Physicians, hospitals and small medical practices are in a race to make sure they are in compliance with ICD-10 codes by October 1st, 2015. Switching their systems over has proven to be a bit more complex than anticipated. The reasons are that ICD-9 codes may have multiple mappings to much more specific ICD-10 codes or no mapping at all. The complexity of each system switch-over is different depending on the medical specialty, the codes normally used to provide services, and the type of office itself. Many providers are turning to special tools to help them make the switch, but in the end the usage of such tools will have to be customized to their particular practice.
Top 5 Tools Available for the ICD-10 Conversion
It would be nice if there were a tool that could automatically transition all ICD-9 codes to their appropriate ICD-10 versions for everyone. However, the nature of the switch means that’s not possible. There is software that can help in that respect, but it will also need human intervention. For that reason, it’s best to focus on getting staff trained ahead of time, which can also be accomplished through some of these tools:
1. General Equivalency Mappings (GEMs) - GEMs are crosswalks provided by the Centers for Medicare and Medicaid Services (CMS) that can help map code equivalences from ICD-9 to ICD-10. They’re not a way to train people, but sort of like a quick lookup for potential code crosswalks. They give general directions, but don’t really go over all the intricacies and nuances inherent in the switch over from ICD-9 to ICD-10 codes.
2. Reimbursement Mapping - This is another crosswalk, created by the CMS in 2011, but it only deals with reimbursements and how the ICD-10 codes might map back to ICD-9 codes. Thus, a healthcare provider can determine how the new ICD-10 codes they choose will affect their reimbursement rates.
3. Proprietary Tools - There are a few proprietary software tools, that can be used to map codes as well. One such tool referred to by RBMA costs about $500. It, purportedly, automates the GEMs available through CMS, but, again, requires some training to apply appropriately. [AS1]
4. Technical Assistance Websites - Sites like CMS.gov that offer valuable assistance to care providers who are having trouble with the switch over are an excellent way to ramp up their efforts. They can provide acknowledgement testing to make sure a claim makes it through the initial checks for processing a Medicare claim, but you have to do it on their time framework. The next round of acknowledgement testing is in June 2015.
5. Other Online Resources for Training - Roadto10.org, by the CMS, is one such site that puts out videos and other training materials for physician practices. The fact that the training is online can help with scheduling issues, so that each member can get the help they need when they need it. Aside from government websites, there are numerous other sites, like AMA-assn.org, devoted to education for physicians or specific practices.
While many of these tools are helpful, they require the ability to learn on your own during a very confusing switch. It can be easier to make the switch over by relying on experts who can answer questions and guide your practice into the best implementation of ICD-10 codes for your specific practice.
We at Healthcare Information Services, L.L.C. (HIS), have a variety of training programs available to provide the guidance that so many offices currently lack during this complex ICD-10 implementation process.
Contact us today.