ICD-10 for Home Health: Where You Should Be Now?

The “go live” date of ICD-10 is only a few months away, and it’s time your agency prepares a solid foundation for the ICD-10 conversion. The ICD-10 transition is likely to affect the reimbursement process that is followed by insurance companies, payers, and the intermediaries that handle those transactions for the CMS. Once the new coding system goes live there will be no grace period, therefore, you must get your home health agency geared up for the October 1st deadline.

Don’t wait till the last minute to update your OASIS and 485s conversions. If your claims are submitted without ICD-10 codes, it will get rejected and you’ll have to resubmit them with the proper ICD-10 codes. This could result in reimbursement delays, reduced cash flow and non-compliance penalties. However, with adequate preparation you can easily avoid these potentially devastating financial and legal landmines.

There are simple steps your agency can take to help prepare for the transition. Here are a few:

  • First and foremost check with your billing service, clearinghouse, or practice management software vendor about their transition plans. If your agency handles billing and software development internally or if you use paper forms, you should plan for medical records/coding, clinical, IT, and finance staff to coordinate on the transition to ICD-10.
  • Keep your eyes open for the updated version of the OASIS data set—OASIS C-1, with revisions to accommodate ICD-10 diagnosis codes in M1010, 1016, 1020, and M1022. M1012 (Inpatient Procedures) will be eliminated.
  • Build up a solid implementation strategy that includes an assessment of the impact on your organization, a detailed timeline, and a realistic budget.
  • Identify staffs and personnel that will require training and start preparing them.
  • Push your clinicians’ knowledge of anatomy, pathophysiology, medical terminology, and pharmacology.
  • Get familiar with ICD-10 codes: Learn the ICD-10 counterparts for the most commonly used ICD-9 codes, gradually orient to the ICD-10 system.
  • Buy an ICD-10 manual, schedule training for your coding staff, arrange coding coverage while coders are in training, and allow for the “learning curve” when ICD-10 finally goes live.
  • Will ICD-10 transition slow your billing process down? Assess your home health agency to see how the transition will impact your billing.

Are you nervous about the ICD-10 transition? Wondering where should you be now? What do you need to do? Check out our informative audio sessions on ICD-10, to dig deeper into ICD-10 transition training.

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