On Monday, July 06, 2015 CMS released a welcome announcement that it will work with the AMA on steps to ease the transition to ICD-10.
Among those steps are:
- Claim denials – for the first year of the code set Medicare will not deny claims solely based on the specificity of diagnosis codes as long as they are in the appropriate diagnostic family of codes. This means physicians won’t be financially penalized because of a coding error.
- Quality reporting – EPs will also not be penalized for errors in selecting and calculating quality codes for the quality reporting programs (MU, PQRS, VBM) as long as they use codes within the appropriate family of codes.
- Payment disruptions – according to AMA president Steven Stack, MD “If Medicare contractors are unable to process claims as a result of problems with ICD-10, CMS will authorize advance payments to physicians.”
- Managing transition problems – CMS plans to create a dedicated communication center to help receive and triage the issues arising from ICD-10 transition.
The above steps will most definitely help in the transition and will alleviate some of the worry among the healthcare community related to the approaching deadline.
ICD-10 transition recommendations for gGastro users
Below are some recommendations to help you prepare your system.
Practice Management interface configurations must be updated to include ICD-10
If you have not yet done so, it is strongly recommended that you reach out to your PM vendor for ICD-10 compliance. If your vendor is able/ready to accept ICD-10 codes, do not delay, contact gMed as soon as possible and request that your interface settings are turned on for ICD-10 inclusion.
Common lists and Patient diagnoses lists must be updated with ICD-10 codes
- Ensure that ALL your user list items in Diagnoses, Impressions and Conditions include ICD-10 codes. gGastro provides an easy visual indication for items with missing codes. Review and update all those items.
- Identify the common ICD-9 codes that translate into multiple ICD-10 codes. Update your favorites lists with the expanded terminology and get your clinicians used to selecting the more specific terms.
- When searching for an ICD-10 code, DO NOT use an ICD-9 code as a search parameter, but use the appropriate term instead. This is extremely important. Because ICD-9 codes are more limited in their definition, searching by the disease/term is the only reliable way to find the appropriate variations translating a single ICD-9 into potentially multiple ICD-10 codes.
- Advise your users to update all patient diagnoses that they come across during the daily interactions.
- Clean up your patient diagnoses lists proactively by using the following steps/reports
Go to Medical Charts – Advanced Search
- Select the option to include patients with missing ICD-10 codes on Problems/Diagnoses (and Conditions if you prefer).
- Select appointments scheduled within a specific period of time
- Run the report.
- From the search results you can access each patient’s chart, Diagnoses section, to clean up any diagnoses that are missing ICD-10 codes.
gMed will execute a mass update on one-to-one diagnosis matches
With your upgrade to version 4.58 or as a separate task for clients in 4.57, gMed team will be able to run a tool for you to update all the user list items and patient diagnoses where there is a one-to-one match between ICD-9 and ICD-10 code. This will allow you to avoid manual updates of thousands of diagnosis entries, where appropriate. You will still have to manually update all those codes which do not have a simple one-to-one crosswalk.
For more information, please contact gSupport@gmed.com.