Medicare Compliance & Reimbursement

Industry Note:

Track Your ICD-10 Progress to Avoid Denials Come October

Not sure where you stand in terms of your ICD-10 progress at this point? The Centers for Medicare & Medicaid Services (CMS) offers detailed advice on how to track the key performance indicators (KPIs) of your progress.

For example, using KPIs, you can evaluate your average claims acceptance/rejection rate. If you want to take that a step further, you can separate out the percentage of claims that your MAC paid in zero to 30 days, 31 to 60 days, 61 to 90 days, and so on.

Your practice may want to perform such KPI analyses now so that you can then perform another one every month to determine whether your denials improve or worsen after the grace period ends on Oct. 1. If you start racking up more denials this October, you can perform further research to find out which ICD-10 codes were billed incorrectly most often, and you can subsequently train your office on how to avoid these mistakes in the future.

Resource: To determine how to track your ICD-10 progress and confirm that your systems are as productive and efficient as possible, visit www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10KPIs20160309.pdf.