Hop Aboard the ICD-10 Train!
It’s coming…
By now, if you’re a regular reader of these blog posts, you are well aware that ICD-10 is coming. As a reminder, ICD-10 is short for the International Classification of Diseases, Tenth Revision.
You can certainly look at our blog archives and check in with our full explanation of the switch from several weeks ago.
This week…
This week saw another behind-the-scenes milestone take place.
The special insurance billing form that we use to bill many insurances, the paper CMS-1500 form, transitioned to a format that will now accommodate the new ICD-10 coding configuration.
In addition, the Medicare Administrative Contractors have begun to accept test files electronically containing hypothetically ICD-10 coded information.
Remember, we’re only a short seven months away from full implementation come March 1st as the deadline to fully transition to the new coding structure will hit on October 1st of this year.
How does this affect me?
The new coding configurations will affect EMS and the resulting EMS billing in a significant way.
If you are a provider, you will not really see the effects of the change in a direct way. However, the billing office that serves your department will be greatly affected by the change and that means that the information you provide to the billing office by means of your Patient Care Report (PCR) will need to be pinpoint detailed.
The change takes place with the new code sets requiring a level of documented medical necessity specificity that has never been required before. We’ve provided some examples in the past, but suffice it to say that everyone has to pick-up their documentation game in the field.
As an EMS administrator, it’s time now to begin to educate your staff and prepare for a possible worst-case scenario.
Staff education should involve reviewing the level of detail, across the board, in your department’s PCR’s. If the PCR’s being completed following EMS runs are lacking in sufficient detail now and the billing office is kicking trips back for further review, then come October 1st your department is going to be hurting.
Cash flow will most likely suffer due to inconsistent PCR’s lacking in detail.
Speaking of cash flow, we also are concerned that many insurance companies and even possibly some Medicare Administrative Contractors will not have their computer systems completely ready to accept ICD-10 coded information. Should this happen, there is a potential for suspended payments and/or glitches that can at the least slow down normal cash flow coming from possibly multiple payment sources.
So now is the time to talk about making contingencies for the “What if’s?”
Ramping up….there is help!
Our billing office is busy preparing now. Is your’s?
If you’re not sure of the answer or the answer is an emphatic “no”, then call us today. It’s time to get moving in preparation for the coming changes. If you need to outsource or change your outsourcing solution we’re ready to help.
Remember, this is not something to wait until the last minute while dreaming that all the pieces will fall into place. Now’s the time to get moving toward a smooth and efficient transition in anticipation of the ICD-10 implementation.
