ICD-10 Physicians Credentialing

Let The Firm Services help you navigate the ICD-10 waters!

by CARL NATALE FEB 16, 2016 – 07:44 PM

Despite the “too-soon-to-tell” lens we’re using to examine the effects of ICD-10 coding, I’m pretty sure the healthcare providers who invested in preparation are doing the best.

Medical practices can continue to “prepare” for successful ICD-10 coding use. Julie Clements addressed this — sort of — when she wrote about the ICD-10 issues encountered in orthopedic injury coding. But she rounds out the post with four tips that can help any medical practice.

Be specific
Sure. The Centers for Medicare and Medicaid Services (CMS) aren’t requiring specificity for Medicare claims. Some healthcare payers seem to be happy with just keeping it in the family. So why worry? But the unspecified holiday will end some time, and Clements warns that unspecified codes could be a sign of insufficient documentation.

Run monthly reports
Remember that ICD-10 advocates promised a golden age of data to be mined from ICD-10 claims. But that’s not going to happen if medical practices are running periodic reports to see what ICD-10 codes are being used. It’s a basic analytics step.

Don’t rely on EHRs
Depending on how good of an IT purchase made, the EHRs may be relying on maps that produce unspecified ICD-10 codes. Clements advises relying on experienced medical coders who can apply the proper ICD-10 codes to the conditions.

Communicate
Allow medical coders and physicians to share information that will help them arrive at the proper ICD-10 diagnoses. This will work way better than queries.

If the physicians groan, remind them that they didn’t stop learning medicine when they left medical school. If they can keep up in the dynamic environment of medicine, they can keep up with what it takes to improve ICD-10 diagnoses and coding.

Questions about ICD-10 reimbursement? Physician Credentialing and Revalidation ? or other changes in Medicare, Commercial Insurance, and Medicaid billing, credentialing and payments? Call the Firm Services at 512-243-6844 or credentialing@thefirmservices.com