Home Health & Hospice Week

Follow these 6 tips for a seamless transition to new ICD-9 codes Oct. 1.

If your staff aren't up to speed on vital diagnosis coding changes by Oct. 1, it could mean a code blue for your bottom line.
 
It is essential for home health agency staff to be using the new ICD-9 codes by Oct. 1 on the dot, stresses Ida Blevins, supervisor of reimbursement and information management for St. John's Hospital Home Health Services in Springfield, IL. That's because the usual 90-day grace period for transition to new diagnosis codes has been eliminated, thanks to HIPAA.
 
"Claims will be affected if we do not submit the appropriate codes on and after 10-1-04," Blevins warns. Claims billed with invalid codes will be returned to provider (RTP'd), requiring correction and resubmission.
 
To avoid reimbursement delays and coding snarls, experts offer these tips:

 1. Review new codes. Look over the new codes, which are available online at www.cms.hhs.gov/medlearn/icd9code.asp, urges consultant Prinny Rose Abraham with HIQM Consulting in Minneapolis. St. John's coders review and discuss the ones most likely to affect home care, Blevins tells Eli. (For codes most affecting HHAs, see Eli's HCW, Vol. XIII, No. 20, p. 154).

 2. Review outgoing codes. "It is just as critical to review the invalid diagnoses list" as to review the new codes, maintains Jennifer Andres, health information and compliance coordinator for St. Luke's Home Health Services in Duluth, MN.
 
"Coding staff have a tendency to memorize frequently used codes, thus coding by memory instead of verifying codes using the code book alpha and tabular indexes," Andres cautions. If you don't alert them to outgoing codes, much time and resources can be lost in fixing and resubmitting claims with outdated codes.

 3. Order new coding books. "At our agency, our new code books are ordered as soon as possible," Andres relates. Backlogged orders are common around implementation time. Some agencies may order just new updates to their books, Abraham notes.

 4. Update internal resources. There are a myriad of places your coding information resides, and if you miss updating one of them it could result in returned claims. Plan your date to update computer servers, desktops and laptops, Abraham advises. If you allow crib sheets, update those as well, she adds.
 
Again, system changes must be in place by Oct. 1 since the grace period is now gone, experts warn.

 5. Educate staff. Training your coding staff on the new codes may be the most important step. At St. John's, the coding is handled by specific coders and discussion groups are scheduled for their training, Blevins says.
 
Timing of your coding sessions will depend on how many staff need training and how it is done. "There needs to be communication as soon as possible in order to ... train their staff on their use," Blevins stresses. The changes now are only a month away.
 
However you arrange your coding training, it must be done before the implementation date for the first time this year, Andres reminds agencies. "It is essential to review the coding changes prior to Oct. 1 with coding staff, and clinical staff, as appropriate," she emphasizes.

 6. Oct. 1 and later. Your job isn't done once the deadline rolls around. When the system changes take effect, Andres tests some known coding changes "to ensure the updates were completely pushed through by our software vendor," she tells Eli.
 
And the most beneficial process of all might be the simplest, Andres adds - she throws out the outdated coding books as soon as the new codes take effect.

Beginning next year, HHAs must start undertaking this process twice a year, Blevins notes. In 2005, codes will be updated in April as well as October. 
 
Editor's Note: For more information on diagnosis coding, see Eli's Home Health ICD-9 Alert. Call 1-800-874-9180 for a free trial subscription today.