Why and how must you immediately begin preparations for the ICD-9 to ICD-10 conversion?


Last year, the much debated ICD-9 to ICD-10 conversion deadline was delayed another year and set to October 1, 2015. However, numerous provider groups and stakeholders have been pushing for another delay, which would be the third in total, stating that the conversion will result in unmanageable financial pressure on the already challenged practices.

This article summarizes how ICD-10 differs from ICD-9, what the Congress had to say about the deadline, and in what way must you prepare for the conversion.

CureMD ICD-9 Into ICD-10

The new codes

The first question that most providers have is about the specific changes in the code sets. Here’s a summary:

* 68,000 diagnosis codes as opposed to just 13,000 in ICD-9

* A maximum 7 alphanumeric characters per code as opposed to 3-5 in ICD-9

* Very specific, more complex, and more flexible codes

* Lateral codes as well (different codes for right and left)

* 87,000 procedure codes as opposed to 3,000 in ICD-9

* 7 alphanumeric procedure code characters in contrast to 3-4 numbers in ICD-9

* With detailed methodology descriptions, procedure approach mechanisms, more detail, and flexibility

The Meeting

Last week, the Energy and Commerce Committee’s Subcommittee on Health held a public forum to discuss the ICD-10 deadline. The meeting panel comprised of experts and stakeholders from across the industry, and included doctors and EHR vendors.

The Response

Despite opposition from a few stakeholders who held the view that small practices wouldn’t be able to manage the new codes, the majority voted in support of the October 1 deadline.

The way forward

The response by the congress via the meeting is clearly tilted towards ensuring that the deadline holds. If you were anticipating a delay, and haven’t yet started working on the conversion; you can still manage. Here’s how:

  1. Contact your EMR and Practice Management vendor and enquire your system’s readiness for the conversion. Ensure that their software possesses the necessary updates and ICD-9 to ICD-10 conversion mapping tools to make certain that your system is ready for, and will facilitate the conversion.
  2. In the case that your vendor is not ready, immediately begin looking for a new system. This is because from October 1, your claims will not be processed on ICD-9 codes.
  3. Delegate an ICD-10 expert (from you staff, or hire a professional) to train your staff, and to devise and execute plan for the conversion in line with your practice workflows.
  4. Consider Outsourcing Medical Billing if your ICD-10 expert (and yourself) feel that your current staff will not be able to manage claims processing on the new code set.
  5. Get in touch with payers and clearinghouses to determine their readiness.

The target for completing these steps (apart from staff training which could be ongoing) should ideally be March 15.

  1. Next, you must begin internal testing of the new codes between March and April, to check how well your staff will manage the new codes. Ideally you should be done by this till the end of June at maximum; and make the necessary workflow adjustments to fix errors in which the process proceeds.
  2. After internal testing in June, you need to begin external testing with clearinghouses and payers to determine how well your test claims (with ICD-10 codes) will do once out of your practice.

It is imperative to identify and correct any slow or disruptive processes in every stage of your conversion process. Doing so will enhance the efficiency of your practice, and help make certain that you are ready and equipped for the ICD-9 to ICD-10 conversion by October 1.

Narrowing down your EHR options


Adopting an Electronic Health Record (EHR) system is no longer an option, but an obligation. If your practice does not do so, you’ll be subject to penalties that will increase as time progresses.

Additionally, you will be deprived of the incentive payments that many of your competitors are benefiting from. However, with several hundred EHR vendors to select from, you require an EHR pricing and vendor comparison to make the right decision.

While the most important component of most decisions is price and costing, you still must develop an initial plan to determine which EHR vendor is appropriate including the how-much-will-it-cost-me component.

First you need to limit the number of vendors on your option base. For doing so, you will first need to identify several vendors based on your personal knowledge, market research and on recommendations of other physicians.

Look at the software and hardware their systems require. For example, a server-based system will require more hardware. Additionally, many of the leading vendors have EHR solutions that do not require installable software and can be accessed via internet. So first, you need to be sure of the solution you require.

Once this comparison is done, you should narrow down your options by a more specific EHR software assessment. In this, you’ll analyze specific features that you require in your EHR. Which vendor is ready for ICD-10 and Meaningful Use Stage 2 certified, for example. Also do some research on other services offered by these vendors; common techniques for this are via rating and review websites, asking other healthcare professionals and by visiting the vendors’ websites. For example how efficient their customer service is and if they have integrated systems (if you require practice management solutions as well).

Now with your options even more limited, conduct an EHR pricing comparison to determine which vendor has solutions that meet your budget. During this stage, include all costs such as those needed for the implementation, average staff training costs and any potential cost that you can think of.

Are Electronic Health Records Saving Time for your Practice and Patients?


Although deadlines for adopting Electronic Health Records (EHR) systems are fast approaching, a cloud of uncertainty over these cloud-based systems still looms large. Here’s how EHR systems would save would save time for both your patients and you:

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With just a laptop and an internet connection, you can view your entire clinical data in addition to connecting with patients, hospitals, other providers, labs, payers and etc.

To guide you through the automation-process, consider a patient Alex, for example. Alex sets up an appointment and comes to your practice complaining of a stomach ache. After the nurse completes the objective portion of the visit, which includes his taking his vitals and other basic information, you assess this objective and subjective data and give your diagnosis before recommending what needs to be done next.

EHR systems allow you to document this entire process online, and readily forward relevant information to labs, pharmacies, etc. Moreover, With all your patient records safely stored on the password protected cloud EHR, a few clicks and you’ll know Alex’s entire patient history; what he’s is allergic to, the results of his last test and the ones before that, his previous pharmacy visits, and virtually every specification you require. The result, improved accuracy and enhanced patient care, readily available and accessible information which saves valuable time and money for both Alex and his physician and an exponential drop in duplicate tests and faulty prescription-based allergic reactions and accidents.

Furthermore, patient portals on EHR systems allow for increased interaction and patient engagement, by which you can respond to Alex’s medical queries online, and allow him to view lab results, prescriptions and other information via the portal, depending on the access you allow.

Read more on Patient Portals.

Accelerated revenue cycle, productivity and compliance are some other benefits of EHR systems.

Meaningful Use Deadline Almost Upon Us


Why is the fast approaching October 1, 2014 Meaningful Use (MU) deadline the talk of the healthcare industry? What happens if you do not start reporting by July 1? This article provides a simple breakdown of the situation.

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MU defines the use of Electronic Health Records (EHR) within an organization. The Center for Medicare & Medicaid Services (CMS) gives financial incentives via Medicare and Medicaid EHR Incentive Programs to providers who demonstrate the “meaningful use” of certified EHR technology. The incentive programs have three stages which beginning by meeting the Stage 1 requirements and subsequently progressing to the next stages.

Stage 1 has to do with data capturing (vitals, demographics, etc), while stage 2 is for advanced decision making (advanced clinical support) and stage 3, which will begin 2017 onwards, will focus on quality measures.

This is the last year to receive Medicare incentives for MU Stage 1 for which reporting begun as early as 2011.  If a provider does not start reporting by July 1, 2014, he will not be able fulfill the 90-day reporting requirement, and hence attest by the October 1, 2014 deadline. Consequently, he will not be eligible for the Medicare incentives.

Additionally, the Medicare penalty for providers who fail to start MU even in the last quarter of 2014 will be subjected to a 1% penalty (in 2015). The penalty will rise by one percent in subsequent years until 2017 after which the penalties are set to vary depending on the percentage of eligible professionals who are meaningful users.

See more on Meaningful Use.

Furthermore, while Medicare is taxable, Medicaid is not. The last year for receiving Medicaid Incentive Program benefits is 2016, however, there is no penalty for this program.

By adopting Meaningful Use and complying with the CMS requirements, practices will be able to enhance quality, safety, efficiency, care coordination, population and public health, reduce health disparities, and engage patients and families for their benefit, all while adhering to privacy and security norms.