ICD-10 Compliance Step 2

Get Ready Now with the New CMS Quick Start Guide!

While ICD-10 is almost here, you still have time to get ready. But you must get ready now.

This week CMS is highlighting the 5 steps from the new Quick Start Guide: 1) Make a Plan, 2) Train Your Staff, 3) Update Your Processes, 4) Talk with Your Vendors and Health Plans, and 5) Test Your Systems and Processes. The focus of this article is:

Step: 2 Train Your Staff

• Train staff on ICD-10 fundamentals using the wealth of free resources from CMS, which include the ICD-10 website, Road to 10, Email Updates, National Provider Calls, and webinars. Free resources are also available from: 
  • Medical societies, health care professional associations 
  • Hospitals, health systems, health plans, vendors 
• Identify top codes. What ICD-9 diagnosis codes does your practice see most often? Target the top 25 to start. You might want to look at common diagnosis codes available from: 
  • Road to 10 (see Specialty References) 
  • Medical specialty societies 
  • Using the documentation available, code current cases in ICD-10. Flag any cases where more documentation is needed.

Tips

• Training for clinical staff—e.g., physicians, nurse practitioners, physician assistants, registered nurses—should focus on documentation, new coding concepts captured in ICD-10 
• Training for coding and administrative staff—e.g., coders, billers, practice managers—should focus on ICD-10 fundamentals 
• You can review your superbills, encounter forms, and practice management system reports to identify your most commonly used ICD-10 codes 
• If time permits, expand your ICD-10 coding of current cases to include 50 or more of your top codes, until 80% of your claims are covered 
• You don’t have to use 68,000 codes—as you do now, your practice will likely use a very small subset of ICD-10 codes 
• You will use a similar process to look up ICD-10 codes that you use with ICD-9 
• While crosswalks from ICD-9 to ICD-10 can be useful references, ICD-10 codes should be based on the clinical documentation rather than selected from a crosswalk 
• Practices that do not prepare for ICD-10 will not be able to submit claims for services performed on or after October 1, 2015

To learn more about getting ready, visit cms.gov/ICD10 for free resources including the Road to 10 tool designed especially for small and rural practices, but useful for all health care professionals.

Keep Up to Date on ICD-10
Visit the CMS ICD-10 website for the latest news and resources to help you prepare. Sign up for CMS ICD-10 Industry Email Updates and follow CMS.gov on Twitter.