Physicians, practice managers, clinics, and hospitals are counting down to October 1, 2015, the day that new health care coding requirements go into effect. The new catalog of codes, from the 10th revision of the International Classification of Diseases – or ICD-10, for short – will include 80,000 diagnostic codes, up from the 14,000 codes that are currently used. Originally scheduled for use beginning October 2013, the Obama Administration delayed ICD-10 until October 2014, and then Congress kindly gave healthcare providers another year, until October 2015. That date, dreaded by large hospitals and single-physician facilities alike, is now upon us.

Are you ready for ICD-10? Perhaps you, like many larger hospitals and healthcare provider groups, have been planning for the change for years, hiring consultants, training staff, and installing multi-million dollar IT systems to handle the transition. After all, vital revenue streams will be at risk. From the start of business on Thursday, October 1, claims for any procedure not using the new codes will be denied by health insurance companies, Medicare, and Medicaid. Yes, doctors, clinics, and hospitals will be able to resubmit claims denied due to incorrect coding, but the extra time and effort to resubmit will cost valuable staff time, and delay reimbursements. And we all know what that means – your cash flow could end up gasping for breath.

It’s not too late to strengthen your practice to prepare for October 1st, and beyond. Here are a few things you can still do to get ready for ICD-10:

Look into a line of credit to make sure you can pay your bills and make your payroll while you’re waiting for some of those denied claims to be resubmitted with brand new, ICD-10 friendly codes. Some banks are even offering special ICD Lines of Credit or loans that can be used for any expense related to ICD-10, including payroll, staff education and new hires, upgrading software and technology, delays in insurance remittance, practice expansion, marketing, and equipment purchases.

You might not be able to afford to hire a team of ICD-10 experts like most of the biggest hospitals in the country have done, but it might be worth the cost to engage a professional coder with expertise in your medical practice specialty. One code in the old system will most likely be replaced with dozens of options in the new system. A coding consultant will look at your practice’s medical records and assign new codes to describe conditions and procedures.

Tighten up your accounts receivable procedures. Institute new policies to collect the patient’s share of the bill – any insurance deductibles and co-pays, as well as unpaid balance’s on the patient account – on the day of the appointment. In fact, many providers report collecting such payments from patients when they sign in for the appointment, before they are sent back to see the doctor or undergo a procedure.

Look carefully at your current – and future – staffing needs. Collecting payments in advance of service, coding claims and properly submitting paperwork, then revising and resubmitting denied claims, as well as tracking your reimbursements through the system, will all take more of your valuable staff time. If you need new people, hire and train them as soon as possible.

Determine if you will need to perform additional tests to help determine the most exact diagnosis and treatment for a patient. For example, since the codes for bone fractures and injuries under ICD-10 will be especially complicated (requiring a more exact, specific diagnosis) several of our orthopedic surgeons are adding extra diagnostic imaging modalities to their practices – a CT scanner, MRI, or DEXA, in addition to basic X-Ray. In fact, adding a refurbished CT system to an orthopedic practice has been a recent trend among our own customers – but the operative word here is “refurbished.” ICD-10 reimbursement codes won’t distinguish between a scan done with a brand new $700,000.00 CT scanner and the refurbished one you snagged for $250,00.00. Think you can’t afford to buy medical equipment and comply with ICD-10? Well, go back up to #1 on this list – your ICD-10-related loan or line of credit can legitimately be used to purchase equipment.

This last tip might seem a little crazy – it won’t add to your bottom line, but it may cut some of the tension you’ve undoubtedly been feeling in anticipation of October 1st – have a laugh. After all, some of the new codes are, at first glance, real headshakers. Do you regularly see patients with crocodile-related conditions? Then you’ll want to update Code W58.13 in your new ICD-10 arsenal. W58.13XA is the new ICD-10 code for “Crushed by Crocodiles – Initial Encounter,” while W58.13XD is the appropriate code your patient’s “Subsequent Encounter” with a crocodile. Here in South Florida, on the edge of the Everglades, that’s the kind of fine distinction that makes us look forward to October 1st.

Countdown to ICD-10 here: https://www.cms.gov/Medicare/Coding/ICD10/index.html?redirect=/icd10(link is external)

If you have any questions or would like more information please call 800-722-3646 or contact us!