Greater Accuracy for Better Reimbursement
Due to the impending transition to the ICD-10 on October 1, 2014, managers, coders, billers, and providers need to be prepared to make the switch as smoothly and as accurately as possible. The new system contains about 5 times more codes compared to ICD-9—that’s 69,000 codes, not to mention the new layout of how the codes are organized. While the increase in the volume of codes seems formidable, much of the increase is due to bilateral eye diagnosis codes (right, left, bilateral, non-bilateral, and unspecified). For example, currently procedures are reported with modifiers RT and LT. With ICD-10, most Eyecare diagnoses will be reported by eye or eyelid. The second major issue is specificity. More codes will mean more specific descriptions of diagnoses.

That being said, there are numerous organizational and managerial tasks that need to be performed in preparation for ICD-10. These include, but are not limited to, preparing and implementing a training program, reworking fee tickets, updating practice management software, establishing documentation policies, and an internal audit system to ensure accuracy, compliance, and maximum reimbursement. Don’t wait; the time to act is now! Be prepared for this transition by learning from a certified coding expert with more than 15 years of experience.

COURSE CONTENT

DOCUMENTATION ISSUES

• ICD-10 guidelines overview
• Practice management system
• Electronic medical records system
• What will you use? A book, a cheat sheet, or a look-up program to select the new ICD-10 codes?
• Integrate the new ICD-10 codes into the Local Coverage Determination (LCD) and medical necessity requirements of carriers

CONCEPTS AND PREPARATION

• What is GEMS?
• What are the new guidelines that I need to know?
• How much time should I allocate toward ICD-10 training?
• To-do list of tasks that must be performed before October 1, 2014
• The importance of eye anatomy to ICD-10 coding
• The importance of medical terminology for ICD-10 coding
• Why a crosswalk is a first step but not sufficient for accurate coding

SPECIFIC IMPLEMENTATION PLAN TOPICS COVERED

• Establishing a training schedule
• Reworking the clinic fee ticket
• Learning the structure, organization, and unique features of ICD-10-CM
• Using assessment tools to identify areas of strength/weakness in medical terminology and medical record documentation
• Pre-implementation audit of the assessment documentation by providers
• Review any documentation from carriers concerning ICD-10
• Review your practice management and your EMR system
• Developing good coding and documentation habits
• Establish a ICD-10 review team

SPECIFIC EYECARE CODES

• Common Eyecare acronyms and how they translate to ICD-10
• Bilateral and non-bilateral codes
• Eyelid ICD-10 codes
• Signs and symptoms codes not specifically related to Eyecare
• Injuries and accident codes
• Top peripheral codes (e.g. diabetes, hypertension, etc.)
• Late effect codes now listed as “sequela”
• Foreign body codes

GOALS AND OBJECTIVES

• Reduce denied claims
• Reduce improperly documented claims
• Report accurately all ICD-10 codes
• Develop good documentation, coding and billing habits early

Audit-proof your clinic