ICD-10: To Train or Not to Train?
By Caleb Clarke
We’re getting close. The much anticipated transition to ICD-10 is set for Oct. 1, 2015 – only five months away. While many people are adamant that we must move forward, there is still talk of another delay. This puts healthcare professionals, especially those in small practices, in a tough position.
Aside from all of their external partners (payers, clearinghouses, software vendors, etc.), coders, billers, and physicians have a lot to learn to adapt to the new changes in coding standards. To spend significant time training and preparing, only to be hit with another delay, can be very frustrating.
Personally, I think the deadline will hold, and I believe ICD-10 will benefit our industry immensely in the long run. That said, findings from our recent “Attitudes Towards ICD-10” survey make me a little uneasy.
The survey says …
A little background: We’ve conducted three “Attitudes Towards ICD-10” surveys since 2012. Our goal is to get a sense of whether or not people’s attitudes and expectations are changing as we near the transition deadline. In the past, we saw significant resistance to ICD-10, especially among smaller practices. This year was no exception.
Right off the bat, we asked respondents how they felt about the new coding standards and the proposed timeline. In both cases, the top response was “There should be no transition to ICD-10” (a little less than a third for both questions). Unfortunately, these numbers aren’t much different than those from the past two surveys.
Participants reported the highest level of concern for “claims processing,” with 65 percent saying they’re “significantly” or “highly” concerned. When asked how they expect the switch to affect certain areas of their business, “finances” and “operations” drew the most negative outlook, with 70 percent saying they expect negative effects.
Training, or lack thereof
To get an idea of how much progress people are making in terms of training, we asked about their level of concern as it relates to “training and education” — the majority (56 percent) said they were “significantly” or “highly” concerned.
When we asked how confident they were that their employees will be adequately trained by October 1st, 35 percent said “not at all confident,” with only 11 percent noting they are “highly confident.” Five months out, we had hoped those numbers would be a little more skewed in the positive direction. So that brings us back to the question at hand …
To train, or not to train?
We know it can be tough with the chance of another delay looming, but … yes, train! Even if there is another delay, it’s too risky to wait. People’s concerns about claims getting backed up and finances struggling are very real threats. It can be difficult to account for all of your external partners, but one thing you can do is make sure your coders, billers, and physicians are comfortable and ready with the new code set.
If you’re able to spend a little extra time and money, there are several training programs you can invest in. For example, both the AAPC and AHIMA offer training webinars, resources, and assessments. Prices for the materials generally range from $100 to several hundred dollars each.
We also highly recommend checking out RoadTo10.org, the “one-stop source for all things ICD-10” from CMS. You’ll find a wealth of free information, including ICD-10 basics, physician perspectives, and webcasts on preparing and documenting for your specialty.
And perhaps the most simple, and most effective, way to train …
Practice, practice, practice!
Both the code set and the documentation style needed to accurately code are changing significantly. While ICD-9-CM included 14,025 diagnoses codes, ICD-10-CM has 69,823 codes – almost five times as many! This expansion is due to a much higher level of specificity. In the long term, it’s great – we’ll be able to much more accurately classify diagnoses and learn from the data. But in the short term, that’s a lot of learning.
Start with your list of common ICD-9 codes. Many coders and billers can rattle off their top 20 without thinking twice. Now they need to reach that same level of comfort with the new, expanded set of codes. Using a tool like ICD9Data.com, you can see how your most common ICD-9 codes map to ICD-10.
Additionally, the AMA offers simple “Snapshot Coding Cards” to help you find the right ICD-10 code. They offer cards for a number of different specialties, and they’re pretty cost effective (around $20 each).
While coders and billers are familiarizing themselves with the new code set, physicians should become comfortable with an increased level of specificity in their documentation. They should take the time to learn new codes as well – at least the most common ones. If they understand the level of specificity coders need to do their job, it will save a lot of frustrating conversations later (“Remember that patient you saw three days ago?” … “No.”).
To all the small shops out there who are struggling to prepare, I hope these tips and resources offer a little help. Even a few minutes per day can go a long way in keeping cash flow strong and steady through October 1.
Caleb Clarke is director of strategic development, sales, and marketing at NueMD.