Preparing for ICD-10: last minute considerations

Preparing for ICD-10 is just a matter of collecting the best information to keep on hand.

Oct. 1 is approaching quickly, but many chiropractors still need to master the basics of ICD-10, train staff, and ensure software and office procedures are prepared for the transition.

If your office is not ready, starting your preparations now will help prevent problems later. Find out how to prepare yourself and your staff.

Focus on your own training

Rather than simply shuffling your staff off to a training seminar, remember to obtain proper training yourself. Doctors need to understand the changes introduced by ICD-10 well enough without help from their staff.

Evan M. Gwilliam, DC, CPC, says that he sees plenty of chiropractors avoid ICD-10 seminars and instead send their chiropractic assistants or office staff.

Gwilliam is a chiropractor, a certified professional coder and Vice President of the ChiroCode Institute. As the deadline draws near, he has spent much of his time on the road teaching seminars about ICD-10.

“Staff members and billers are going to turn into trainers, whether they want to or not,” Gwilliam said.

For doctors, the key to transitioning well to ICD-10 is to focus on their own education regarding coding and documentation. Williams recommends that chiropractors choose a different patient each day and create practice documentation using the new coding system.

Since the deadline is so close, Gwilliam suggests that chiropractors set aside enough time for intensive personal study. Courses and seminars, like those Gwilliam teaches, allow participants to absorb ICD-10 information thoroughly in-person or online.

Practice makes perfect

Practice billing claims are also helpful, and Medicare is accepting practice claims before the first, Gwilliam says. Doctors should also contact their billing clearinghouse or contact their state’s Medicare office about submitting a practice claim.

Doing practice documentation every day and one or two practice claims will help you ensure that your own knowledge and implementation of ICD-10 is fully compliant.

Begin the transition now

Making a plan will help create an easier transition. Take time to identify how you will guide your practice into the new system. Once you understand ICD-10 basics, you can begin applying these new changes and developing a self-audit strategy to ensure compliance throughout the process.

If you do not have a list of ICD-10 codes, be sure to put together a list of new codes that you can refer to as you learn.

“We certainly recommend that, by now, they’ve created their own personal list of their most commonly used diagnosis codes so that they can map them over to ICD-10 and find their equivalents,” said Kathy Mills Chang, MCS-P, a consultant and coding specialist who is also president and CEO of KMC University, which provides educational training and assistance to chiropractors.

Dual coding

Chiropractors should begin dual-coding existing patients in order to bring ICD-10 codes into their records, as Chang suggests. New patient records should be coded in ICD-10 from the beginning. Your billing and coding software should be capable of dual-coding, so it makes sense to begin using the new standard and becoming familiar with it.

Having patient records that are already dual-coded makes the transition easier, since the old codes are easy to remove later and the new codes make these records already compliant, as Chang recommends.

Maintain compliance with internal auditing

Keep your practice compliant with the new standards by establishing your own internal auditing procedures. Being prepared for possible outside audits will keep you and your staff accurate while helping to protect your practice from potential liability.

Chang says that chiropractors should closely watch their practices’ billing claims, looking carefully at the first claims filed on and after Oct. 1. Documentation should also be examined carefully. Understanding how ICD-10 changes documentation helps chiropractors make this transition properly.

“There are certain rules they [chiropractors] have to understand before they can even learn the documentation,” Gwilliam said. “It’s really important for them to understand documentation before they start learning about claims.”

Since each code requires proper documentation, Chang suggests that chiropractors understand how each code’s documentation differs. Chiropractors must be sure that they are using each code correctly to describe the patient’s diagnosis. Since ICD-10 adds additional complexity to the documentation process, chiropractors should be sure to understand each code.

Get help if you need it

Choosing an online or in-person class and using available resources online from the Centers for Medicare and Medicaid Services such as the “Road to ICD-10” website will help you get your practice better-prepared.

Even if you procrastinated and have yet to begin moving to the new standards, you can start now and be in a better position when the deadline arrives. If you need extra help, make use of the many excellent training programs, seminars, and consulting services available.