Struggling with ICD-10? Here’s Where to Get Help

By: Michelle Cavanaugh

It’s finally here. ICD-10 went into effect for dates of service on Oct. 1, 2015 and after. Amazingly the world did not end. In fact, for many, the transition seems to be going ok so far, but for others, it’s a bit of a bumpy road.

This is not surprising since the level of preparedness among practices and payers varied pretty widely heading into this change. So, if you’re running into problems, where can you go for some help?

First, be sure you are using all the tools available to you from your software vendors. If you haven’t already, check out any ICD-10 resources, features, help articles from your vendor. There might be some tools, tip or tricks you weren’t aware of.

Next, tighten up your claim tracking and denial management. According to Betsy Nicoletti, founder of codepedia.com, an online resource for coders, “The principles of preventing and managing denials in ICD-10 are the same as in ICD-9.” It’s just that the chance of denials is higher so you have to monitor it more closely. Use whatever tools you have at your disposal to monitor claim progress and address denials quickly.

Still need some general coding or billing help? Then, you might also consider some additional training through an organization like AAPC or AHIMA. Your specialty society is another good place to look. If you didn’t do this before it could come in handy now that you have a sense of the ICD-10 claims process.

If you have covered your bases on these items and still run into issues then it is time to look at some outside resources. Recently, CMS release a letter from the Deputy Administrator with some guidance and resources. In it they explained what they are doing to help with the transition. They also offered some suggestions for resources for practices.

If you need more help, CMS suggests these resources:

• For general ICD-10 information, use the Road to 10 webpage;

• As a first line for help for claims questions, contact your Medicare Administrative Contractor

• You can also contact the ICD-10 Coordination Center; and

• The ICD-10 Ombudsman, Dr. Bill Rogers, can be your impartial advocate.

To keep your cash flow from suffering, get help as soon as you see a problem. Don’t wait it out or hope it will resolve itself. If ever there was a time to take advantage of the help that is available, it is now.