Make the Most of
ICD-10 Coding Changes in 2017
An experienced medical coding company can help physicians navigate
ICD-10
coding
requirements
and
optimize
reimbursement in the changing healthcare landscape.
Outsource Strategies International www.outsourcestrategies.com
8596 E. 101st Street, Suite H Tulsa, OK 74133
Phone: 1-800-670-2809
Ever since the ICD-10 flexibilities ended on October 1, 2016, physicians have sought to submit claims with clinical documentation that reflects as much specificity as possible. Medical coding companies have worked to educate physicians about the level of granularity required for ICD-10. However, as a report in Medical Economics notes, it is likely that physicians will continue to experience the impact of the ICD10 transition in 2017 in the form of payer requests, denials, and the new code set’s influence on value-based care. While medical coding outsourcing can help providers make the most of ICD-10, here are some things that physicians should know
to
ensure
proper
reimbursement
and
meet
quality-of-care
reporting
requirements: Optimal use of EHR for documentation: The templated EHR note has structured, dropdown boxes and also a section for a narrative note. Using a cut-and-paste documentation approach could save time, but it cannot capture the complete clinical picture of the patient. To quickly capture discrete data in the EHR, physicians should use the software’s advanced options to ensure a combination of detailed structured data elements and a narrative note for completeness and accuracy. Denial management: Analyzing a practice’s claim denial rate is the best way to assess the efficiency of its billing and coding. Practices should conduct audits to identify why claims were denied -- starting from their pre-ICD-10 baselines. This will provide a clear picture of how physicians captured clinical data and how their medical coding service provider accessed and interpreted the information. Payers are likely to be more aggressive about demonstration of medical necessity. Understand MACRA: Physicians need to be educated on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) which establishes value-based
payment
programs
for
physicians
treating
Medicare
beneficiaries. MACRA implementation is scheduled for January 1, 2019. Under MACRA’s Merit-based Incentive Payment System (MIPS), participating providers will be paid based on the quality and effectiveness of the care rather than on volume as in the fee-for-service system.
www.outsourcestrategies.com
Phone: 1-800-670-2809
ďƒ˜ Monitor clinical documentation improvement: In addition to tracking their clinical documentation improvement (CDI) program, physicians should benchmark themselves against peers. Successful CDI programs ensure that patients’ clinical status is accurately represented so that it translates into coded data. This, in turn, promotes quality reporting and physician reimbursement. The ideal environment is one in which physicians measure and share data, which allows them to stay competitive. ďƒ˜ Foster team effort: As physicians need to focus on care, achieving ICD-10 coding goals requires a team effort. All clinical support staff should be involved in everything from data capture to patient care, which will make it easier for the practice to maximize coding opportunities and revenue. ICD-10 and value-based care models have altered practice workflow and the revenue cycle management landscape. Relying on an experienced medical coding company would help physicians navigate these new challenges and drive improvements in ICD-10 coding. The coders in established companies know how to make use of resources to quickly find the right information when questions arise. They are knowledgeable about anatomy and physiology and understand how procedures are performed, which allows them to apply the right codes to meet quality-of-care goals and ensure optimal reimbursement.
www.outsourcestrategies.com
Phone: 1-800-670-2809