ICD-10 has been called one of the most comprehensive healthcare initiatives in the past 30 years. With a much larger code set than ICD-9, the increased size of ICD-10 provides the ability to code medical diagnoses with better accuracy. Also, unlike ICD-9, the new code set enables providers to document and report the technology used in procedures, providing a level of granularity
that will help medical imaging deliver enhanced service to patients on initial and recurring visits.
Even with these big benefits, ICD-10 still has its share of pain points. The greatest impact for medical imaging will be on radiologists and their coding staff
. Radiologists will have to be sure to thoroughly dictate the required information into reports so the coders can apply the correct ICD-10 codes to the procedures performed. The coders will be responsible for making sure all the required data is present and coding the procedures correctly to avoid delays and denials.
However, these are not the only groups impacted. Office staff, such as schedulers, will need to know what to look for when orders come in as more information is required to code correctly and, in most cases, the imaging center does not have access to a patient’s medical history. Imaging centers should begin working now
to get referring physicians into the habit of sending all the required information in orders, so that coding can be completed correctly. Schedulers will need to identify when information is missing and have a good working relationship with the referring doctor’s office to follow up when orders are incomplete.
The days when providers could order a wrist X-ray simply for pain are numbered. Under ICD-10, orders will need to include details such as laterality, encounter and possibly even the patient’s healing status. Providers should also be re-thinking how to dictate their reports so coders get all the information they need to properly code the procedures. Incorrect coding will lead to delayed payments and possibly even denial of payment in some cases. Finally, providers should ensure that staff is up-to-date on coding requirements for ICD-10—depending on their certifications, coders may be required to recertify for compliance.
This may all sound like a tall order, but Merge can help providers navigate through the ICD-10 transition. To ensure our customers have the ability to store and report with both ICD-9 and ICD-10 code sets, Merge has implemented a corporate-wide initiative and is working fast to update all of our appropriate radiology, cardiology, orthopedic, lab and perioperative solutions in the next few months. In fact, the latest release of the Merge Financials™
solution will be able to fully support dual coding so providers may submit claims in either format requested by payers. In addition, the upgrades coming for Merge RIS™
will include a crosswalk tool and offer the ability to record ICD-10 codes and the update coming.
Thanks to a one-year postponement, ICD-10 doesn’t take effect until October 2014. While that may seem far away, time flies, and the Federal government has made it clear that there will be no more delays. Therefore, providers, especially those in image-intensive fields like radiology, cardiology and orthopedics, should begin taking the appropriate steps
and prepare now.
If you haven’t already started, it’s time to get ready. Where are you in the transition process?
To learn more, register and attend one of Merge’s upcoming webinars happening this month.