Costly ICD-10 Pitfalls and How to Avoid Them

The switch to ICD-10 doesn’t have to be crazy-expensive, but if you make a couple of big missteps, your whole practice could take a financial tumble. Like navigating a magical hedge maze to retrieve the Triwizard Cup, making the transition to ICD-10 could be full of costly pitfalls. Here are three common ways ICD-10 can empty your bank account—and how to avoid them:

1. Weak Cash Flow

During the transition to ICD-10, it’s possible you may experience a delay in payments due to coding errors and vendor or payer under-preparedness. That’s why you need to do everything in your power to make sure your revenue stream keeps flowing. To that end, you should first assess your current billing workflow to determine how quickly and cleanly your practice currently processes and receives payment for claims using ICD-9 codes. This will allow you to correct any kinks in your workflow and give you a much better sense of how ICD-10 could affect your cash flow after the transition. Depending on the results of your assessment, you may need to consider hiring coders, better training your front office staff on billing, or working with an automated billing service or software.

2. Poor Productivity

While we can expect a certain degree of diminished productivity during the transition, it shouldn’t be severe—or permanent. To keep your clinic running at top speed, start by determining your practice’s most commonly used diagnosis codes and their most specific ICD-10 equivalents. That way, your staff can spend more time billing and less time searching for codes. While you’re at it, a recent Medscape article recommends that you start phasing out unspecified diagnosis codes. Not only can unspecified codes give way to questions that bog down your billers, but they also can cause ICD-10 claim denials.

Another way to prevent productivity loss is to ensure your billing, practice management, and EMR vendors—and payers—are ready for ICD-10. First, find out which of your vendors and payers will be affected by ICD-10. Then, you’ll need to:

  • Determine their testing processes and schedules.
  • Submit and review test data.
  • Update your billing process—and perhaps your vendors—based on the results of your testing.

For more details on external testing, check out our blog post here.

3. Lack of Training

Just as investing in Apple stock when it first went public in 1980 was a good idea, so is training your staff on ICD-10 now—before it becomes a big to-do. Otherwise, you’re in for a rough transition—complete with heaps of staff frustration. Switching to ICD-10 isn’t exactly a small change. The new code set has 55,000 more codes than ICD-9. To further complicate matters, while ICD-9 codes are mostly numeric and have just three to five digits, ICD-10 codes are alphanumeric and contain three to seven characters. So, while some folks will feel the impact more than others, all of your staff members should go through some kind of ICD-10 training to ensure everyone is on board with the change and understands the new coding requirements.

Be patient and flexible with your staff while they learn the new structure, but make sure you develop—and stick to—a training timeline and strategy. To vary your educational style and keep costs down, take advantage of free educational tools, like ICD-10 for PT and the WebPT Blog. We’ve got tons of articles, webinars, handouts, checklists, quizzes, and games to help prepare your staff for the switch.

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Knowing three of the most common ICD-10 pitfalls for PTs—and how to arm yourself against them—will help you avoid a financial fiasco come October 1. But that doesn’t mean the transition will be totally easy. Make sure you download The Physical Therapist’s Crunch-Time Guide to ICD-10, and don’t miss WebPT’s upcoming webinar—ICD-10 Bootcamp: Coding Exercises for PTs and OTs—on August 31, 2015, at 9:00 AM PDT / 12:00 PM EDT.