External testing update and tips for a successful conversion

April 1, 2015

Independence has begun testing with large health systems, which include hospitals, physicians, and clearing houses. We will be communicating our testing experience and lessons learned to network providers to ensure a smooth transition to ICD-10 by October 1, 2015.

Tips for a successful conversion

Steps you can take to ensure a successful transition to ICD-10:

  1. Make a plan
    • Identify which ICD-9 codes you use heavily.
    • Identify staff that need to be trained in medical coding and/or documentation.
    • Contact vendors to learn their transition plans, ICD-10-related costs to the practice, and resources available to the practice.
    • Contact the specialty societies or the Centers for Medicare & Medicaid Services (CMS) website for any resources available to the practice.
  2. Get trained
    • Buy or download an ICD-10 diagnosis codebook.
    • Arrange and obtain documentation training for physicians and other clinicians.
    • Crosswalk common diagnosis codes to ICD-10 and identify new requirements or differences in essential documentation.
    • Sign up for key CMS webinars to increase understanding of the ICD-10 environment.
  3. Update internal practice tools
    • Convert superbills to ICD-10.
    • Convert other materials to ICD-10, such as authorizations, orders, and referrals.
    • Identify current code-related claim denials and areas where ICD-10?s specificity in documentation and code assignment can address this.
    • Obtain payer medical polices with ICD-10 codes for comparison.
  4. Work with vendors and payers
    • Arrange and implement ICD-10 software upgrades and training for staff on use of new software, either directly or via the vendor.
    • Identify electronic health records documentation templates and assess how they support ICD-10 specificity for claims submission and medical necessity.
    • Engage payers on any discrepancies and omissions in ICD-10 coding for medical policies.
    • Identify if payers anticipate any changes in processing and payment due to ICD-10.
  5. Test the process
    • Perform testing on systems within the practice.
    • Perform end-to-end testing, where available.
    • Identify and correct issues encountered during testing.
    • Educate staff on the impact of ICD-10 to payer edits, adjudication, and other claims elements to processes within the practice.

For the most up-to-date information, including updates on external testing, frequently asked questions, and dial-in information for the next What's Up Wednesday call, please visit our dedicated ICD-10 web page and be sure to read future editions of Partners in Health UpdateSM.