Commencing ignition sequence in 10-9-8… It’s that time folks! ICD-10 is here and ready or not October 1 is happening. As we here at Aym begin our final preparations for this historic event, we wanted to take a few moments and share some last minute suggestions.
The following is a list of things that you should have already done to be ready on 10/1:
- Confirm with your vendor that they are ready for the transition
- Populate an ICD-10 diagnosis for all of your consumers in your respective EHR, EMR, or billing software
- Test your 837 file with ALL payers that you send billing to (if you bill via a portal, call to confirm that the portal is ready for post 10/1 use)
- Contact your bank to discuss emergency cash flow options should things go badly for you.
- Conduct training with all of your clinicians and billing staff to make sure that everyone understands what is required of them post 10/1
That was the easy stuff! Now, here are some other things to think about as we near the finish line for the biggest single transition to hit our world in the last decade:
- Diagnosis code groups – It’s not enough to just have any old code assigned to your consumers. The ICD-10 code you use must at least match the correct diagnosis code group. Hopefully you have utilized one of the many crosswalks that exist online to help you migrate your codes, but if not please take the time to ensure that you are getting an accurate ICD-10. Many ICD-9 codes map to multiple ICD-10 options, so don’t assume that the correct code is simply the first one that you come to.
- Taxonomy – Many payers have been remiss in keeping up with edits and audits surrounding Taxonomy since the 5010 transition several years ago. For most, they have only been looking for a value in the taxonomy field rather than ensuring that the code being used is appropriate to the provider type and service being billed. Unfortunately, that means that many of you may have been getting paid for claims that actually had an incorrect taxonomy attached to it. Now would be a great time to take a second look at this and clean up any issues.
- Provider NPI and Address Mappings – Again, for many payers it was simply enough that you included an NPI and ZIP+4 that contained in your contract. Now, payers starting to require that the NPI and ZIP+4 on the claims EXACTLY match the one that was used on the authorization request. Seems easy enough right? But we are finding many instances where large providers with multiple regional offices are getting all tangled up in selecting the correct billing and attending combo for the claim. Also, yes it does matter that you moved from suite B to suite D two years ago but never remembered to update your BCBS contract. Those details may now come back to haunt you in the form of claim denials.
So, as with most behavioral healthcare transitions, the devil is in the details. How you manage those details will have a huge impact on how much cash you collect after October 1st.
If you feel you need help getting across the finish line on this critical transition, please email us. We are here to help!