Eli's Hospice Insider

Published on Tue Jan 15, 2013 PDF

A working budget should encompass every aspect of planning, including productivity training.

With all of the challenges hitting your hospice lately, ICD-10 planning may be on the back burner. But Medicare’s focus on hospice diagnosis coding combined with a coming hospice payment overhaul may make you rethink your priorities.

Reminder: In its 2013 wage index notice for hospices this summer, the Centers for Medicare & Medicaid Services urges hospices to get up to speed with diagnosis coding compliance. "Hospice claims which only report a principal diagnosis are not providing an accurate description of the patients’ conditions," CMS chastised in the notice in the July 27 Federal Register. "Providers should code and report coexisting or additional diagnoses to more fully describe the Medicare patients they are treating." (For more, see Eli’s Hospice Insider, Vol. 5, No. 9.)

The ICD-10 implementation date of 2014 really is just around the corner, so the time to prepare is now, experts urge. Hospice providers can benefit from tips offered during a recent CMS National Provider Call, "Preparing Physicians for ICD-10 Implementation."

"Education and patience are key," said Ginger Boyle during the call. Boyle is a practicing family physician who has developed a coding education program for her hospital and its family practice residency program. Her presentation broke down the ICD-10 transition into the following six phases:

1. Planning.

2. Communication and awareness.

3. Assessment.

4. Operational implementation.

5. Testing.

6. Transition.

In other words: To begin, you should establish the project structure, responsible parties, and highlight clinician and coding champions who can be assets. You should also create your budget. Be sure to include software upgrades, training needs, and productivity loss/gain.

Then, talk to all those involved, which may include office administrators, vendors, providers, clearinghouses, payers, and other associates.

You need to monitor the impact on the following aspects: personnel, claims, reimbursement, denials, and rejections.

Bottom line: "Once you create a timeline, you need to stick to it," Boyle urged listeners. CMS finalized the ICD-10 compliance date of Oct. 1, 2014, as stated in the Sept. 5, 2012, Federal Register. When ICD-10-CM goes into effect, you should apply the code set and official guidelines in effect for the date of service reported.

Note: More information on ICD-10 is at www.cms.gov/Medicare/Coding/ICD10. For more information on the transition to the new coding set, subscribe to Eli’s Home Health ICD-9 Alert at www.elihealthcare.com.

You can order a recording of Coding of Hospice Cases, an audioconference presented by coding expert Lisa Selman-Holman at www.audioeducator.com/codingof-hospice-cases.html or call 1-866-458-2965.