Coding and Billing

ICD-10: Educational Resources to Get Staff on Board

By Edwin Liu, OD,
and Eric M. White, OD

SYNOPSIS


Prepare your staff to implement ICD-10 coding by next October. The payoff is better patient care and fewer costly claim denials.

ACTION POINTS

INVEST IN EDUCATION. Seminars, such as those provided by Primary Eyecare Network (PEN) ready doctors and staff for this upcoming change.

UPDATE YOUR TECHNOLOGY. Optimize EHR coding functionality and combine if needed with software solutions to aid ICD-10 transition.

GET STAFF BEHIND ICD-10. Emphasize to staff how greater specificity in diagnosis and treatment plan improves care and minimizes rejected claims

Edwin Liu, OD, a partner with

Foothill Optometric Group
in Pleasanton, Calif., and
Eric M. White, OD, the owner of 
Complete Family Vision Care
 in San Diego, Calif.,
share how they are readying their practices for ICD-10
by
 the mandated October 2015 deadline
. A key resource for these doctors and their staffs has been their optometric alliance,
Primary Eyecare Network (PEN) and its billing and compliance partner,
CSEye.

Invest In Education–and Needed Technology


Edwin Liu, OD
Partner with Foothill Optometric Group
Pleasanton, Calif.

As you look at the new ICD-10 coding system, the first thing you realize is that you will need the assistance of a coding software program to help you through the process. In our office, we had to increase our internet speed and bandwidth by bringing in fiber optic high-speed internet service. Many of the current electronic health record (EHR) systems are ready for ICD-10 coding. However, programs like EyeCOR do an excellent job at assisting the doctor in selecting the correct diagnostic codes and service levels. John McGreal, OD,  has been conducting PEN-sponsored presentations on medical coding and billing for years, and continues to be a valuable resource in preparing for the upcoming changes.

ICD-10 Preparation Checklist

Debra Foster, Dr. Liu’s office insurance coordinator, offers this checklist to prepare for ICD-10:

UPGRADE. Make sure your practice management software is ICD-10-capable. The ability to automatically convert ICD-9 to ICD-10 is extremely helpful.

COMMUNICATE. Contact all of your practice’s payers and vendors to make sure they are ready for the conversion.

STREAMLINE PROCESS. Make a cheat sheet of common diagnoses and their ICD-10 codes to begin familiarizing doctors and staff.

PREPARE. Practice during summer 2015 by coding real patient visits to increase familiarity.

Optimize Educational Programming

Debra Foster, our office insurance coordinator, has attended not only the McGreal seminars, but also an online course from the Centers for Medicare & Medicaid Services (CMS) and an all-day seminar from the National Provider Compliance Corporation. She has worked hard to ensure the office is ready to go in October by reviewing and practicing the new coding process with our other employees.

Invest in Needed Software & Use EHR Coding Functionality

ICD-10 has forced our office to utilize the available computer software, such as EyeCOR to streamline our coding and billing process. This includes getting all of the doctors on board in the use of the software, along with our billing department. Moving forward with the Affordable Care Act, utilization of these kinds of software tools will be a prerequisite in order to participate in the medical healthcare arena.

Incorporating new computer software into a practice is never an easy process. Creating an implementation plan has required collaborative meetings with our practice doctors and supervisors to make sure we develop a sequential plan, with clear steps and deadlines. We check every two weeks to do a quick review of where we are in the process of transitioning to ICD-10.

Most of the major optometric EHR systems have the capability of converting ICD-9 to ICD-10 choices. I say “choices” because IDC-10 is much more specific than ICD-9 and requires more detail in the diagnosis. EyeCOR is an excellent stand-alone coding software program that can be integrated with any of the major EHR systems. PEN has a number of resources and seminars to help in the ICD-10 transition process, and companies like CSEye can walk you through the implementation process and help you with the billing process on an ongoing basis.

We found EyeCOR to be easier to use and better at finding the right diagnostic code and appropriate service fee than our current office EHR system. CSEye is an organization that can help with offices that are unprepared, or unsure of how to prepare their office for the ICD-10 transition. These additional resources are helpful for practice owners in need of basic help to begin the transition process. We have used CSEye as consultants on occasion, but currently are preparing for the ICD-10 transition in-house.

Get Comprehensive Patient Histories

A complete patient medical history is an essential requirement of ICD-10, and calls for scheduling changes and patient education about why this information is needed. With our EHR system, the patient has a portal to their medical history form online, and is asked to fill it out before their scheduled appointment. Those without computer access are asked to come in 30 minutes early to complete all of the paperwork.

Use ICD-10 to Address Coding Challenges

We have coding challenges to address that ICD-10 may help us with. I believe ICD-10, combined with the use of EyeCOR and our EHR’s built-in coding functions, will result in fewer rejected claims and more accurate coding, resulting in increased practice revenue.

Educate Now, Enjoy Greater Efficiency Later


Eric M. White, OD
Owner of Complete Family Vision Care
San Diego, Calif.,

PEN has been invaluable in preparing for the monumental transition to ICD-10, thanks to its McGreal billing and coding courses. I know most offices are saying “we will worry about this later,” but this is such a big change, we need to start preparing soon.

Educate & Offer Staff On-Demand Educational Resources

PEN has pamphlets available to staff that can serve as cheat sheets as they work with ICD-10. We started last year preparing by having my practice’s biller complete PEN’s ICD-10 coursework.  The pamphlets and other in-office materials from PEN will give my staff on-the-job guides for how to code the most common conditions we treat.

Set Goals for Transition

I want to be comfortable with the changes well before the October 2015 deadline. Our goal is, by June 1, 2015, to have the office comfortable with the new codes. If everybody starts now to familiarize themselves with the coding system, then when the time for the transition comes, it will not be a shock to our practice’s operations.  We were not ready in 2014, so the federal government moving it back a year was the best for us.

Use ICD-10 to Increase Coding Accuracy

Despite the challenges of making this transition, there are clear benefits to ICD-10 compared to ICD-9. The biggest benefit is ICD-10 takes the guesswork out of the diagnosis in the code and the doctor’s determination of how to treat it, since the new coding requires the doctor to stipulate both those things. This requirement for greater specificity in coding of conditions, diagnosis and treatment will help all of us to know our practices better and to be able to treat our patients more efficiently. Rejected claims, which take up a good portion of my biller’s time and wastes money, will be reduced. By forcing greater specificity in coding, ICD-10 will make rejected claims less likely, enabling us to be paid faster and our practice to run more efficiently.

Edwin Liu, OD, is a partner with Foothill Optometric Group in Pleasanton, Calif. To contact him: 2020eliu@gmail.com.

Eric M. White, OD, is the owner of Complete Family Vision Care in San Diego, Calif. To contact him: Emwhiteod@aol.com.

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