practice management consultant who is certified as a professional coder and a professional medical auditor.
Review office technology upgrade requirements
Physicians should expect to upgrade their practice management and elec- tronic health record (EHR) systems to accommodate the new ICD-10 code sets. You might need new hardware, as well. “It’s important for the physician to
look at what their overall goals and plans are for technology upgrades first,” said Shannon Moore, director of health information technology for TMA. “For instance, if they are getting a new prac- tice management system, many elec- tronic health record companies offer a companion practice management system that is included in the price of the EHR. What’s nice about this is you don’t have to integrate two disparate systems.”
Suggested action Ms. Moore said that although TMA does not recommend physicians choose a combined practice management sys- tem and EHR software package, doctors moving toward implementing an EHR should compare the benefits against the costs of having two different systems. An electronic medical record system cost- comparison tool, which doesn’t include potential hardware costs, is available to members on the TMA website at www
.texmed.org. Click on Practice Help, then Technology.
When considering a practice’s hard-
ware needs, “you always want to buy above your current needs,” Ms. Moore said. “Get a little bit more to allow for growth and additional capability.”
Train the entire office “Training and education are going to be key,” Ms. Buckholtz said. “Almost every single person in the practice will need some training in ICD-10 to perform his or her job.” This spring, TMA is hosting a series of hands-on ICD-10 training workshops. Practices also can arrange on-site ICD- 10 training sessions with a TMA practice management consultant.
“If there is not a certified coder in the office, the physician ought to look into getting staff certified as professional cod- ers,” Dr. Spain said.
Nine steps to ICD-10 compliance The ICD-10 compliance deadline is less than two years out on the horizon. AMA published the “ICD-10 Timeline: Meet- ing the Compliance Date” to help medi- cal offices prioritize their preparations. The timeline’s nine critical steps require a minimum of 22 months to complete, so most physician offices should already be taking action to ensure that staff, of- fice technology, and internal operations are ready to make the switch on Oct. 1, 2013. The estimated completion times in the AMA timeline apply to larger prac- tices, according to Dr. Spain. Smaller practices should be able to move faster through the nine steps. Step 1: Conduct impact analysis (minimum estimated time to com- plete: three months). Medical offices should review information about the ICD-10 code set and gain a basic un- derstanding of the differences between ICD-9 and ICD-10. They then should conduct an impact analysis on their busi- ness practices and systems to determine how the switch will affect operations. Next, they should complete an inven- tory of all systems, both electronic and manual, that use ICD-9 codes. By con- ducting this review as early as possible, health care providers will be able to fully understand the scope of work ahead and prioritize important tasks. Step 2: Contact vendors (mini-
mum time to complete: two months). Physicians should contact their vendors to learn about the dates, expected costs, and other specific details regarding the installation of the ICD-10 upgrades to their computer systems. This could be included in the discussions they have about upgrading to v5010 HIPAA transactions. “Make sure vendors are already testing v5010 transmissions,” Dr. Spain said. Physicians should ask vendors if
they’ll maintain updates to the ICD-9 and ICD-10 code sets during the tran-
sition period and if they’ll provide any “crosswalk” tools between the two code sets.
“Have a conversation about whether the company will continue to support this system throughout the conversion,” Ms. Moore said. “You don’t want to be caught off guard because your practice management software company couldn’t keep up.” Step 3: Contact payers, bill-
ing service, and clearinghouse (minimum time to complete: two months). Medical offices should reach out to their payers, billing services, and clearinghouses to learn when their ICD- 10 upgrades will be completed and when they’ll be ready to begin testing transactions using the new codes. Like- wise, doctors should let these groups know when they expect to have their of- fice system upgrades installed. Moving to the ICD-10 code set may
require renegotiation of contracts, so physician offices should ask about changes these groups plan to make to their processes for reviews, audits, cov- erage, and medical policies, as well as how those changes will affect coverage decisions and reporting requirements. “It is important for doctors to work with health plans so that they continue to have feasible contracts for payment after Oct. 1, 2013,” said Ms. Buckholtz. “Many payments are tied to quality re- porting, performance, and medical ne- cessity. Physicians will need to work with health plans to avoid any disrup- tions or decreased revenue.” Step 4: Install vendor upgrades
(minimum time to complete: three months). Because the timing of system upgrades to a medical office is depen- dent upon the readiness of the vendors serving that office, it’s important for physician office staff to talk with ven- dors about upgrades early on, even as vendors are preparing for the v5010 up- grade. This also may help reduce ICD-10 transition costs. Other systems, such as quality-reporting tools and public health reporting, should be upgraded at this time, as well. “Be sure to ask your vendor about quality-reporting tools,” Ms. Moore said.
February 2012 TEXAS MEDICINE 27
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