To gain the necessary knowledge for a successful transition, training will be essential. While classes are available to- day, starting too soon can create unnec- essary work and may require additional training as details are finalized. I recom- mend that your ASC’s coders start train- ing no earlier than six months prior to the deadline date.


2. Train physicians on documentation. Research shows that approximately 75 percent of current physician docu- mentation is inadequate for support- ing ICD-10, reaffirming the need for physician training. This training will need to come from the coders. There- fore, it is essential that your ASC’s coders begin their training well be- fore the deadline so that the physician training is not delayed.


3. Talk to your vendors about their transition plans. Talk to your hardware and software vendors to make sure they have transi- tion plans in place. It is very important for ASC administrators to stay on top of their vendors; this includes request- ing a written plan for what will be done to ensure ICD-10 compliance.


4. Talk to commercial payers about their transition plans. As with vendors, it is important to un- derstand transition plans for commer- cial payers. Written plans will ensure that there is no miscommunication between your facility and payers.


5. Make a contingency plan for workers’ compensation. A contingency plan for workers’ com- pensation is particularly important if your center is orthopedic-driven. While there is a carve-out that allows entities that are not covered by the Health Insurance Portability and Ac- countability Act (HIPAA) to continue to use ICD-9 code sets, it is important to make sure that your system can sup-


port both ICD-9 and ICD-10 code sets. Additionally, contact your non-HIPAA covered entities, (e.g., workers’ com- pensation and property and casualty insurers) to verify whether they plan to transition to ICD-10 code sets.


ing System (HCPCS) codes you will want to discuss those contracts with the payer. These steps will help ensure that you have a good checklist of the functions and processes that will be affected by the transition.


Contrary to what many believe, the impact on day-to-day operations will go beyond just billing.”


—Kevin McDonald, SourceMedical


6. Follow a “day in the life” of a diagnosis code within a facility. Because ICD-9 codes are not limited to billing departments, it is important to identify everywhere codes are be- ing used. Enlisting the help of each person within your organization via an email request will help you iden- tify where the codes are being used so that no area is overlooked during the transition to ICD-10. Ask employ- ees to identify which forms are elec- tronic; those that are not will need to be changed.


7. Determine which policies and procedures will be affected by ICD-10. Evaluate your current workflow to identify processes that will be af- fected by the ICD-10 code set change. Most people tend to correlate this change only to billing, but your as- sessment should include all daily functions, such as scheduling. Also, don’t forget to review the standard reports you commonly use as well as both your printed and electronic docu- ments, such as your consent forms, to ensure that all documents that contain a diagnosis code are integrated into your plan. If you have payer contracts that base reimbursement on ICD procedure codes instead of Current Procedural Terminology (CPT® Healthcare Common Procedure Cod-


) or CPT copyright 2012 American Medical Association. All rights reserved.


8. Consider outsourcing. It is going to get harder and harder to find qualified coders. The majority are going to have to go back to school or receive additional training to learn how to implement the new coding system. For more experienced coders, it could be a pushing point for retirement. Many will not go forward with their certification given the complexity as- sociated with ICD-10. With the potential pool of available


coders expected to decline, it is likely that they will demand higher salaries. As a result, this could be a good time to consider outsourcing. When negotiat- ing with outsourced billing companies, lock in billing rates for as many years as you can as rates will likely climb as im- plementation of ICD-10 nears. Longer- term agreements can provide significant cost savings in the years to come. For ASCs that are already outsourcing, now is the time to renegotiate terms to se- cure a longer-term agreement.


Kevin McDonald is senior vice president, ASC & Sur- gical Hospital Billing Ser- vices for SourceMedical.


Contact McDonald at kevin.mcdonald@ sourcemed.net.


The advice and opinions expressed in this ar- ticle are those of the author and do not rep- resent official Ambulatory Surgery Center Asso- ciation policy or opinion.


ASC FOCUS NOVEMBER/DECEMBER 2012 13


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