Many clinicians describe the change to ICD-10 codes as exciting, but others use words that include scary and expensive. Training in the use of the new codes will be required for many employees, especially for coders/billers, which has many in the profession viewing the transition with trepidation.

ICD 10 codesThe American Health Information Management System (AHIMA) has determined that it will require about 16 hours and $500 to fully train coders working in a small practice who are already experienced in ICD-9 protocols.

The training expands to 57-62 hours for all others. AHIMA indicated that most coders should receive their training three to six months prior to ICD-10 implementation so the information remains fresh in their mind.

More Codes For All

ICD-10 contains 141,000 alpha-numeric codes, but all practices won’t use the full complement of codes.

General physicians may use 30 more, while rheumatologists and orthopedic surgeons may use up to 60 percent of the new codes. ICD-10-CM codes are used for a diagnosis and description of symptoms.

ICD-10-PCS codes are those that will be used to describe procedures, but only in the U.S.  for inpatient hospital environments.

Easing The Transition 

Using an EMR and computer assisted coding will significantly reduce problems. EMRs are capable of handling all the new codes. Additionally, some systems identify potential problems and notify billers/coders before the claim leaves the office for reduced denials.

The systems still rely on human operators and will help alleviate an expected reduction in productivity the new codes will engender.

One problem that many have overlooked is a decrease in morale associated with the transition. Many coders/billers are anxious and nervous about the new coding.

Their primary worry is being able to maintain the expected cash flow to practices. It’s a legitimate concern and one that clinicians and billing specialists will need to work on together.

Training Opportunities

The Centers for Medicare and Medicaid Services, the World Health Organization, professional billing/coder organizations, and some insurance providers have developed training modules and tools to assist individuals in their quest for reliable training options.

Coders are the professionals that bridge the gap between clinicians and insurance companies to ensure practitioners get paid.

One of the biggest problems facing billers/coders is finding the time to learn ICD-10 coding while maintaining their normal work day with ICD-9 coding.

Online education is a convenient remedy that can be a cost effective solution for practices.

ICD 10 codesPlan For Contingencies

The best way to learn is by doing and professional coder/biller organizations highly recommend that anyone who will be working with the new codes conduct simulations using actual claims.

The exercise provides practical experience and helps familiarize coders/billers with codes before the official rollout.

Clinicians need to establish a crisis committee to formulate a backup plan to accommodate slow-downs in reimbursements during the first few months.

The U.S. is one of the last countries to adopt the ICD-10 coding and it’s coming at a time when many practices are still involved in meeting meaningful use standards and changes associated with Obamacare.

When Canada implemented ICD-10 codes in the 2000s, productivity was sharply reduced for months and the same is expected for the U.S., but many problems will be greatly alleviated through appropriate planning.