5/26/2013 – Kameron Gifford, CPC
Where will ICD-10 impact your organization the most? What are you doing to protect your revenue?
The greatest hurdle in transitioning to ICD-10 will be improving
clinical documentation.
Are your providers documenting with the specificity required
for ICD-10? If not, where do you focus your education?
If you have not already completed a revenue risk assessment,
I urge you to do so now! This will be your greatest key to success!
Start with a Revenue
Risk Assessment for your Organization:
Medicare Advantage Plans/ MSO’s / IPA’s:
1.
Compile a list of your most frequently billed
ICD-9 Codes per provider. (A list of 25 is sufficient).
2.
Map these codes into the corresponding ICD-10
Codes.
3.
Map ICD-10 Codes to Corresponding HCC’s to
determine potential impact on revenue.
Prior, Proper,
Planning…
Once you have determined the potential impact on revenue we
can use this same information to create meaningful education to improve
clinical documentation.
We are by nature, creatures of habit, and we must start
changing the behavior of providers now to ensure adoption of new concepts.
A few examples of these include:
• Laterality – left, right, bilateral or unilateral
• Trimester of pregnancy and weeks of gestation
• BMI calculation in
Obesity
• Which finger, and which
level in a finger amputation
• The type of surgical approach for procedures
• The severity of
seizures
• The severity of retinopathy or renal disease in diabetics
Compliant coding begins with compliant documentation. Through
accurate risk revenue assessments organizations can concentrate their efforts;
thus encouraging greater engagement.
If your organization needs help contact ERM. We will audit up to 10 dates of services or map 10 codes at
NO CHARGE.
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