Advantage Medical ICD-10 Training Update

We are back from our very intensive ICD-10 training.  And although the massive number of code selections are daunting, the coding path which advises insurers of what exactly has transpired at the visit can now be made very clear.  It has always been difficult for coders to tell a story effectively using current codes and being limited to only 4 diagnoses to tell the entire story.  The seven character field will allow for growth down the road and the reporting will provide medical and technology solutions to the most reported codes and conditions due to their high level of specificity. 

What is important to know is that the level of documentation required from the Provider will be critical in order to be able to code the claim and be paid for the level of services provided at each visit.    Some specialties will be impacted greater than others.   Some of the specialties with the most impact are Cardiology, Opthamology, Orthopedics, and Neurology with Orthopedists having the most difficult transition. 

The Provider and Coder/Billing Company are going to need to be clear about who is doing what and how its being done as well as the required resources.  We are working with our software vendors, clearinghouses, our staff, and our Providers so we have a clear picture of each individuals responsibility and time lines in the process.

There are many resources available to make this transition easier for everyone.  Some of the ones we will be using are cross coder cards for each specialty.  We will be providing these to our providers to help them with the transition.  We will also be using software that will assist us with coding and cross coding from the old codes which we know so well to the many codes that replace them.  All of these things are amazing but will not work without the Providers documentation.

We always go back to the Providers documentation and so do the insurance companies, so its extremely important to make certain your Providers understand what is required of them.  We are ready for October 1, 2014 and we know it will be challenging, that is why we are prepared.  Do yourself a favor now and be prepared for what you do know is coming, so you will have the time for what you don’t know about, and there is always plenty of that with this type of transition.

Just a reminder, the new CMS1500 was in effect on January 6, 2014 for use but if you have old forms you can use them until March 31, 2014 when they will then become obsolete.

As always, if you need help with your billing, we would be happy to hear from you. 

                                         “Take Advantage”  call 1.877.666.5279

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