Whether quickly adjusting to an individual's changed health status or streamlining a conversion to electronic health records, medical facilities must have resources and strategies in place to prepare for and execute change. The same concept applies to ICD-10-CM transitions. Read on to determine whether your healthcare system is ready:
A breakdown of this year's updates
The next batch of updates will take effect October 1, 2016, and they are more impactful than years past. That's because code freezes have made this the first annual update in five years. Here is a breakdown of what healthcare systems can expect:
The sheer number of changes demonstrates how vital it is to be proactive about the transition, but that requires having the right resources in place.
Hospitals must update their systems to accommodate for the ICD-10-CM changes to ensure the terminology providers use when entering claims is accurately interpreted by insurance companies. In turn, this allows insurance companies to provide appropriate reimbursement.
Perhaps the best way to execute this part of preparation is to have programs that allow for automatic updates. Depending on your EHR vendor, you may have access to the IMO 2.0 Enhanced Terminology Platform (ETP) providing the most current dictionaries and tools:
Relying on ETP ensures updates occur across the board in healthcare systems, taking care of perhaps the most substantial adjustment necessary in ICD-10-CM update preparation. Additionally, medical facilities should designate a specific individual to download and apply the fiscal year 2017 ICD-10-CM changes.
The greatest challenge for providers in transitioning to the latest ICD-10-CM will be documenting with new, higher levels of detail. In fact, a driver of the fiscal year 2017 ICD-10-CM updates was for clinicians and coders to more accurately capture the care provided to patients in their electronic health records, according to the Journal of American Health Information Management Association.
Having resources in place that allow clinicians to streamline adding specificity to codes ensures they have time to dedicate to delivering care as opposed to just documenting it.
Medical billers and coders
Billers and coders are often the gatekeepers between providers and insurance companies, serving as the final set of eyes reviewing bills. Because of this, these constituents in the healthcare system must have a more comprehensive understanding of the new rule guidance surrounding the ICD-10-CM changes coming in October. This knowledge allows them to ensure all codes are accurately portrayed in claims. Otherwise, healthcare systems may face reimbursement gaps.
Has your medical facility taken the necessary preparatory steps? While an early start is important, it's not too late to begin arrangements for a successful transition, and IMO is here to help. Our suite of products guides healthcare systems through every step of code transitions.
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