Medicare Compliance & Reimbursement

Take the lead in planning ICD-10 learning activities.

With Oct. 1, 2015 behind us, experts are reminding medical offices that the start of ICD-10 is not the end of ICD-10 training; it’s only the beginning.

“Nobody really knows what we’re in for because we’ve never used it [ICD-10],” explains Maggie M. Mac, CPC, CEMC, CHC, CMM, ICCE, AHIMA-approved ICD-10 CM/PCS trainer and president of Maggie Mac-Medical Practice Consulting in Clearwater, Fla. Due to ICD-10’s newness, coders and providers will have to learn the intricacies of ICD-10 while simultaneously using the new diagnosis coding system. Practice managers can assist in the training process by facilitating training opportunities and, in some cases, taking the lead in planning ICD-10 learning activities.

Help’s here: There are ways that you can mitigate any ICD-10 blues your office might experience, however. Check out these quick tips from a pair of expert ICD-10 trainers.

Providers Need to Heed Coders’ Documentation Advice

In order to be as compliant as possible with ICD-10, coders must constantly communicate with all providers who treat patients — including all physicians, clinical nurses, physician assistants, etc. — to hone their documentation skills. Practice managers can help by coming up with a way to ensure that the providers and coders get together and talk ICD-10.

Ideally, “each of your coders and clinicians will understand all the aspects that go into a claim from the moment a patient walks in (through) the door to the time you receive payment from the payer,” says Alicia Scott, CPC, CPC-I, CRC, a trainer with Certification Coaching Organization, LLC, in Oceanville, N.J. Obtaining this knowledge will not happen overnight, however. There has to be an information pipeline between coders and providers to get the ICD-10 codes straight.

Coders must be the office professionals that possess “completely comprehensive ICD-10 knowledge” because they are the ones on the front lines of the coding theater, according to Mac.

Example: Your physician diagnoses a fracture. To code properly for ICD-10, physicians can’t just write “fracture” anymore. There has to be a higher level of specificity; and only coders can know the specifics that payers will expect on the claim.

“The providers need to listen to the coders, who will know more [about ICD-10] than anyone else,” says Mac.

Keep Learning, Practicing, After Oct. 1

In order to stay sharp after the implementation date, Mac advises coders to keep studying ICD-10 and to stay in contact with other coders. Practice managers can steer coders toward the best ways to stay ICD-10 sharp.

“Coders need to get together to do [ICD-10 coding] right. If you don’t know something, ask people that you know have the most ICD-10 knowledge,” explains Mac.

Scott agrees, saying that you should use any resource you can find to up your ICD-10 knowledge. Some of the best ways to stay ICD-10 current include:

• joining online ICD-10 chat forums;
• holding in-office ICD-10 training seminars;
• attending off-site ICD-10 conferences;
• talking with other provider offices, in your specialty and in others, about their ICD-10 experiences; and
• keeping up with ICD-10 guidance from Medicare and private payers.

Best bet: “Learn as you go,” says Mac. “Remember, nobody’s had to implement [ICD-10]. So I don’t think anyone is going to be perfect.”