The fact that the 2015 transition to ICD-10 was not as dramatic a problem as some healthcare providers worried it would be does not mean the system is not without its challenges. Considering a Medicare Part B-related one-year grace period that went into effect late in 2015, some businesses and practices may just now be starting to feel the impact of wrinkles that still need to be ironed out.
Under ICD-10, the number of available diagnostic codes used in billing jumped more than fivefold, up to about 69,000. Because of this, clinical documentation—always vital—has become even more critically important, especially in relation to navigating denials and other reimbursement challenges. While mistakes always happen, especially in times of transition and learning new systems, organizations can do much to accelerate resolutions and mitigate the risk of negative outcomes by having a clear documentation policy in place and routinely auditing their teams and practices to ensure proper procedures are being followed. Being able to quickly find properly documented and filed information is key to handling issues as they arise.
The fact that computer systems will continue for some time to have a need to access both the previous ICD-9 codes and the current ICD-10 codes further complicates the issue, as does the ever-present reality of emerging diseases that necessitate further scrutiny and the ongoing evolution of even fledgling systems. The mosquito-borne Zika virus has been a prime example of this in 2016.
For help in establishing or tightening policies in place to ensure the earliest days of ICD-10 implementation continue to run as smoothly as possible, and that emerging challenges are addressed quickly, contact Professional Medical Management Services at promedcomply.com or call (856) 840-5570.