Your flexible, comprehensive EHR solution! www.pimsyemr.com 8 Easy Steps for ICD-10

8 Steps to a Smooth ICD-10 Transition Ready to get started on ICD-10? Click here and here for ICD-10 background info and see below for Additional Resources – meanwhile, here’s a step-by-step action plan: 1) Talk to your payers: Start calling your payers now, whether insurance companies or Medicaid/Medicare, and find out what codes they will be requiring, especially for your niche market (mental health, ABA, substance abuse, IOP, speech therapy, nutrition, etc). Will they call for any DSM-5? Do they have any special ICD-10 stipulations? Once you know what you need to provide, the path is somewhat set for you.

2) Decide which conversion pathway you want to follow: If y0u don’t use DSM, there’s only one way to go: ICD-9 to ICD-10. However, if you want or need to use DSM, it’s a little more complicated. Do you want to convert from DSM-IV to DSM-5 to ICD-10? Are you already using DSM-5? Do your payers require both DSM and ICD? Pick your conversion pathway and determine how you will convert your codes: there are multiple options available, from conversion crosswalks & software for purchase, to free conversion tools on the Web. Be sure to confirm the

accuracy of whatever conversion tool(s) you choose, as they can differ greatly in quality! 3) Train your staff: After deciding on your best conversion pathway, educate your employees on the predicted changes and how they might affect business. Thoroughly train your staff on the new office practices by late spring/early summer to allow plenty of time for testing. Keep in mind that ICD-10 codes are required for dates of services after 10/1/15, but claims processed with a date of service prior to 10/1/15 should still be coded in ICD-9, regardless of when they are submitted. Additionally, non-HIPAA covered entities such as workman’s compensation are not required to transition to ICD-10. You will need to train your staff on recognizing these distinctions and billing fluidly with both sets of codes. 4) Schedule testing with your payers for late spring/early summer to leave plenty of time for addressing complications before the 10/1/15 deadline. You won’t fully understand how much ICD-10 will affect you until you test the new codes with your payers, so you may need to rework office practices and retrain your employees after testing is conducted. 5) Schedule testing with your practice: The hardest part of this transition will be getting your staff trained to pick the right code and getting used to business under this new framework –

Your flexible, comprehensive EHR solution! www.pimsyemr.com 8 Easy Steps for ICD-10

after you’ve tested with your payers and implemented any needed adjustments (including retraining), test your employees and make sure everything is running smoothly for them.

6) Save and set aside: put away as much money as possible in case payments are delayed during the transition (remember the January 2013 CPT debacle for mental health!?) 7) Create updated revenue plans: if it takes your staff 2-3 times as long to process notes or claims, what changes do you need to make to ensure business viability?

8) Hire an expert: the easiest way to make this challenge as smooth as possible is to secure an ICD-10 expert to conduct a risk assessment of your practice and get you on track for a successful transition. They can determine how much you will be impacted and create an implementation timeline to ensure you are testing the new codes early enough to catch & fix errors and meet the deadline. Because of the complex interactions between DSM-IV & DSM-5 and ICD-9 & 10, it’s a good idea to hire a consultant well-versed in mental & behavioral health.

Additional Resources PIMSY ICD-10 Resource Center PIMSY ICD-10 Forum ICD-10 for Behavioral Health blog How do ICD, DSM, and CPT interact for mental health? Transition to ICD-10 AAPC Fast Forward Top 50 Codes Conversion PDF Centers for Medicare and Medicaid Services (CMS) ICD-10 Provider Resources ICD-10 Implementation Guide for Small and Medium Practices Small and Medium Practices ICD-10 Checklist ICD-10 Implementation Guide for Large Practices American College of Physicians ICD-10 Resource Center ICD-10 Conversion Tool and Resources AAPC Coding Books

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Disclaimer: Ultimately, it is the responsibility of each practice to ensure ICD compliance, including the 10/1/14 ICD-10 transition.

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