Do you file electronic claims? Mark this week: March 3-7. CMS will conduct end-to-end-testing on ICD-10 electronic claims. The goal is to help you determine if all outbound test electronic claims were successful during this test run: submitted, received, and confirmed and/or accepted or rejected. To participate, practices should check with their local Medicare Administrative Contractors (MAC) when registration will open. Learn more about the ICD-10 end-to-end testing, or visit your local Medicare Carrier website for specific instructions. Your clearinghouse may be able to help.
Register now for ICD-10 end-to-end testing.
After participating in CMS testing, find out what your private payers are doing in terms of testing. They will likely be offering similar claims test runs.
Dermatologists who plan to attend the Academy’s 72nd Annual Meeting in Denver may take advantage of the opportunity to hear directly from experts about the ICD-10 transition. Visit www.aad.org/scientificsessions/am2014 and search for “ICD-10” to identify sessions that can help.
If your practice hasn’t started, please begin your ICD-10 readiness assessment and implementation plan.
- For practices with EHRs/PMS: Consult your software license agreement to see how upgrades are handled. Contact your respective vendor(s) to determine when to expect your upgrade and how much it will cost. If you haven’t heard back from your vendor(s), contact them again until your situation is clarified and resolved.
- For practices filing [non-electronic] paper claims: You must still get started on this critical transition. The Academy offers a coding manual, a crosswalk, and webinars/webcasts that can help.
The approved and revised CMS 1500 version 02/12 is available and will be required for all claim submissions effective 04/01/14. Obtain a copy in order to submit your claims on current claim form (see sample).
- For practices using an outside billing company: a two-prong approach is recommended. First, work with your business associate (billing services company) to make sure it is getting ready to meet the ICD-10 deadline. The billing company should be your point of contact when dealing with your clearinghouse and payers. A best practice would be to have regular meetings with the billing company so that everyone is on the same page, using a common implementation plan to plan and prepare. Second, start educating and training the entire practice team so that everyone is familiar and comfortable with the new code set. Continuous training will be required.
How is your implementation coming along? Double check to see if you are on target and/or need to adjust the plan based on your practice needs and external factors. Sign up for the Academy’s May webinar, where you will learn the latest on ICD-10 at www.aad.org/webinars.
- For practices with EHRs/PMS: Assuming your practice has received the EHR/PMS upgrades, you should proceed to focus on internal testing and staff training as soon as possible. If not, find out from your vendor what is causing the delay. The quicker you obtain your ICD-10 upgrade, the more time you will have to ensure practice readiness for the Oct. 1 deadline. This may be a good time to standardize training for all members, including dermatologists, clinical staff, and administrative support staff. But remember that members of the practice team may move at varying speeds as they learn how to use the new diagnostic code set. An ICD-10 certified coder is an asset during this critical juncture; if your practice has one, make sure this team member serves as the point person for all ICD-10 technical questions.
- For practices filing (non-electronic) paper claims: Once you obtain your ICD-10 reference materials, please encourage the entire practice team — including the dermatologist(s) — to start familiarizing themselves with this new coding system. It is advisable to have in-service training; schedule it when the work schedule permits.
- For practices using an outside billing company: Assuming there are regular meetings between the practice and the billing services company, where does the billing services company stand and what updates does it have from the clearinghouse and payers? How is the practice progressing with its in-house training and educational efforts? There are a number of resources available to help dermatology practices at www.aad.org/ICD-10.
Learn the latest on ICD-10 by continuing to visit the Academy’s website. There are resources for the entire practice team. Practice coding batches of encounters using ICD-10-CM codes to ensure you are meeting the documentation, coding specificity expected by the coding system.
- For practices with EHRs/PMS: If you’ve started getting ready for ICD-10, well done! Determine where you are in the implementation cycle. Depending on your progress, determine what else needs to be done either internally or externally — involving your clearinghouse, payers, and/or vendor(s). What are you hearing or not hearing from these key external stakeholders? If you haven’t heard anything, contact each of these business partners immediately because your success will depend on them. If the payers are offering ICD-10 claims testing, take advantage of it so the practice becomes comfortable with the process. Don’t forget to continue your practice team’s training and education sessions.
- For practices filing (non-electronic) paper claims: Where are you in your ICD-10 compliance preparation efforts? If you’ve already obtained your reference materials, available through the Academy website, then you are moving down the right path. Now the entire practice can start practicing how to use ICD-10 and becoming familiar with this coding set. If you haven’t started, you are dangerously close to being left behind. Don’t delay. Obtain all training material to get the entire practice ready. Find out from your payers if there is any news on their paper claims processing policies.
- For practices using an outside billing company: Find out from your billing services company if they are taking advantage of testing mock ICD-10 mock claims with payers through the clearinghouse. By now, the billing company should be able to give a full progress report on its efforts, and identify what remains to be done before October. Equally important, the practice should continue to educate and train the entire practice team.
With the deadline three months away, how is the practice progressing on its ICD-10 readiness? Take advantage of the Summer Academy Meeting in Chicago in early August by registering to attend relevant ICD-10 sessions. Sign up for the
Academy’s ICD-10 webinar here
- For practices with EHRs/PMS: As you plan ahead, determine what else needs to be done regarding the internal practice team’s educational comfort level and external partners’ readiness. If you need to ramp up your readiness efforts, you may need to consider some extra downtime to help your staff increase its coding proficiency.
- For practices filing (non-electronic) paper claims: What is your current readiness status? Based on your specific situation, determine what needs to be done both internally with education and training as well as what your payers are telling you about handling paper claims come Oct. 1.
- For practices using an outside billing company: The billing company should keep you updated on its progress with payers and the clearinghouse. Share with your vendor(s) what you may be hearing from other sources. This is a team effort, and will require all parties' participation to deliver a successful transition. At this point, the practice should have a better comfort level with and understanding of the new code set. If some members of the practice team need more time to catch up, now is the time to help them.
Consider taking advantage of this relatively slow month by determining if a final round of educational training is needed for the practice team. Set aside some days to start training and identify changes in the workflow process. Apply and share what you learned at the Summer Academy Meeting.
- For practices with EHRs/PMS: Learn the latest from your business partners — vendor(s), clearinghouse, and payers. At this point, the practice should start doing final training and software testing to make sure all educational deficits and technical gaps have been addressed in full.
- For practices filing (non-electronic) paper claims: With the deadline fast approaching, it is advisable to check in with your payers to learn the latest about their policies for handling paper claims.
- For practices using an outside billing company: With the clock running down, meet with your billing company to review progress and adjust any task in the implementation plan. The billing company should go over a final report of what the payers and clearinghouse have done in terms of testing and verifying claims transmission readiness. If further work needs to be done, don’t delay. If the practice is experiencing some downtime, use this opportunity to hold weekly meetings to determine staff progress with education and training.
Now is the time final preparations and countdown to Oct. 1! At this point, the practice should be in the final stages of this critical change in its clinical documentation/coding and business operations. Everyone has worked really hard to support this mission-critical effort. One final inspection of the implementation plan is warranted. Make sure all practice team members are fully up to speed and comfortable with their ICD-10 training and proficiency.
- For practices with EHRs/PMS: All business partners — vendors, clearinghouse, and payers — should have final instructions on their “go-live” plans. Find out so that the practice is prepared. The time has come after everyone's hard work and investment.
- For practices filing (non-electronic) paper claims: One last time, find out from your payers about the final checks and updates needed to submit your new ICD-10 paper claims.
- For practices using an outside billing company: At this point, the billing company should meet with key members of the practice to obtain a final progress report and conduct one final walk-through to make sure everything is in place and is ready for a smooth transition.