10/15/2015
5 ICD-10 Tips
To make the most of the next few weeks, the following steps are also suggested:
1. Plan for in-depth audits. These audits should take place 4-6 weeks post-go-live. Where is the organization most vulnerable in terms of ICD-10 documentation insufficiencies? What are some of the most important educational opportunities for coders, physicians and CDI professionals?
2. Increase the lines of communication between coders and CDI. At a minimum, these two groups of individuals should meet weekly to discuss coding challenges and query opportunities.
3. Focus on denial prevention (rather than denial management). At one of our client sites, the ICD-10 steering committee is shifting its focus toward denial management. The committee, which includes the CFO, patient financial services, utilization management/case management, HIM, coders, and IT, will ask these questions:
- Are there payment discrepancies? If so, where and why?
- How do current audit findings compare with those of prior audits?
- Why do medical necessity denials occur?
- What educational opportunities emerge as denials are tracked and trended?
4. Turn your attention toward CAC. Now that we've made the ICD-10 transition, providers can focus on exploring CAC options if they haven't done so already. CAC can enhance coder productivity and also be an important component of a denial prevention strategy.
5. Integrate ICD-10 efforts with information governance (IG). ICD-10 was - and continues to be - a great launching pad for a formal IG program. Use your ICD-10 data maps and data inventories as a foundation for a larger IG program focusing on the entire life cycle of the data, including its creation, maintenance, transmission and destruction.
