Category: ICD-10

How to Reduce ICD-10 Denials

October 16, 2015 Posted on Categories Billing Service, ICD-10

by Michelle Tohill

As you well know, ICD-10 went into effect Oct. 1. Many of you are already submitting claims using the new coding system. In the next few weeks, you’ll find out how well you’re doing based on the number of successful reimbursements compared to rejections.

Avoid costly delays and irritation by following these five steps to reduce ICD-10 claim denials:film Despicable Me 3

1. Review/work claim rejections daily
With the new standards, it’s important to review and work your rejections on a  daily basis. This is good practice regardless of the situation, but with so much change in the system, it is more important than ever to stay on top of your claims.

2. Documentation is essential
Now is the time to make sure that your documentation is completely buttoned up so that you can justify every claim and also quickly correct any errors that you make that result in claim rejection.

3. Education & knowledge on ICD-10 medical billing standards
Hopefully you have good billing software and a billing team that is helping through this transition, but even the best systems and software can’t beat taking the time to really learn the new ICD-10 coding system to reduce errors and eliminate rejections.

4. Avoid using the “Unspecified” ICD-10 codes
This is a red flag, and will likely result in claim denial. If you absolutely must code with an “unspecified” code, provide needed detail associated with the ICD-10 and documentation aiding in meeting medical necessity.

5. Become familiar with the LCD guidelines
Local coverage determination (LCD) guidelines vary from region to region, making it critical that your medical billing software and billing team are familiar with which region applies to the specific care being claimed. Not following LCD guidelines will result in unequivocal claim denial.

Most of these tips are things I recommended before Oct. 1, but now they are even more important. At Bonafide, our software-only customers have the benefit of utilizing our updated software. Of course, our billing customers have the added benefit of our expert team of billers. Let us know if you need some help reducing your medical billing claims!

 

Michelle Tohill is Director of Revenue Cycle Management of Bonafide Management Systems and oversees all billing programs and processes. Her specialty is conducting AR audits to expose inefficient billing practices that fail to fully reimburse physicians for their work. She conducts AR audits and provides Bonafide customers with training and consulting on how to improve every aspect of billing and practice management to maximize revenue.

How is ICD-10 Going to Affect You Oct. 1?

September 23, 2015 Posted on Categories Billing Service, Cash Flow, ICD-10

by Michelle Tohill

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Oct. 1 is right around the corner, and we still don’t know exactly how ICD-10 is going to impact healthcare businesses. In fact, there is still some slight question about whether the CDC is going to pull back at the last minute due to readiness concerns.

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Here are some things you should know for your business in preparation for Oct. 1:

>> You must use ICD-9 codes up through Sept. 30; beginning Oct. 1, you must use ICD-10 codes.

>> If you don’t use the correct ICD-10 codes, you will not get reimbursed.

>> It may take time for your partners and providers to get on board, so even if you are ICD-10 ready, your cashflow may still be impacted due to their inability to provide the correct billing information.

 streaming The Lost City of Z movie

While it’s hard to say EXACTLY what will happen on Oct. 1, we do know that there will likely be a great deal of confusion and an overall slow-down in the medical billing and reimbursement industry for at least the first 90 days following ICD-10 implementation.

 streaming The Lost City of Z movie

If you haven’t already, make sure your billers or billing service is fully ICD-10 ready, and prepare a cushion in your bank account to allow for significant cashflow slow-downs.

 streaming The Lost City of Z movie

Michelle Tohill is Director of Revenue Cycle Management of Bonafide Management Systems and oversees all billing programs and processes. Her specialty is conducting AR audits to expose inefficient billing practices that fail to fully reimburse physicians for their work. She conducts AR audits and provides Bonafide customers with training and consulting on how to improve every aspect of billing and practice management to maximize revenue.

DME Client Checklist: 5 Steps to Prepare for ICD-10

July 28, 2015 Posted on Categories ICD-10

Your Bonafide team has been working hard to prepare for the upcoming ICD-10 transition, which is scheduled to go into effect Oct. 1, 2015. ICD-10 will expand the number of diagnosis codes from 18,000 to 140,000.watch The Invisible Guest film online now

 

We will do everything we can on our end to help ease the transition for our customers. Here is a checklist of what you should be doing to prepare your business for this change. Click here for a visual infographic of this information.download Fifty Shades Darker 2017 movie

 

1. Assess Your Current Situation
Each DME provider will have a different level of complexity in transitioning to ICD-10. Conduct a charge summary by primary diagnosis code. This will allow you to see how challenging ICD-10 will be for your particular business.

Next, identify all systems and work processes that will be affected by ICD-10. This will likely include documentation, encounter forms, superbills, contracts, and more.

Finally, consider your referring physicians. Remember that the largest challenge you may face as a DME provider is poor coding on their behalf. If they fail to use the correct ICD-10 code, it will be up to your team to find the correct code, which will require additional time.

 

2. Make a Plan
Once you know how seriously ICD-10 will impact your business, you should create an implementation plan. The countdown starts now, with full implementation going live Oct. 1.

Your plan should map out exactly how you are going to train your staff, prepare your providers, and conduct billing under the new system. Your plan should also evaluate the costs involved in the ICD-10 transition. In addition to training and implementation costs, you should also create a financial cushion to cover cash flow shortages that you may experience during the transition.

 

3. Communicate
Your implementation plan should include communication strategies for all of the parties with which you interact. In addition to referring physicians, customers and payors, you will also want to consider how you will communicate with your staff, delivery service, billing service, and wholesale suppliers.

Remember that the biggest challenge for DME providers during the transition will be cash flow shortages. This will not always be under your control, and thus you should expect significant hiccups along the way. By preparing communication strategies in advance, you can avoid major problems.

 

4. Get Started
Your plan should outline how to get started, but definitely don’t wait to begin training your staff. Another key action is to start becoming familiar with the most commonly used code or codes in ICD-10 in your business. You can also start obtaining ICD-10 codes from referring providers.

Depending on how you manage your billing, you will want to talk to Bonafide about how and when we are conducting any system tests. You should also familiarize your staff with the ICD-10 crosswalk mapping.

 

5. Get Help if You Need it
At Bonafide, we know how stressful ICD-10 is for our customers. We are developing training materials and programs for everyone. If you would like us to conduct a complimentary assessment of your frequently-used codes to let you know how seriously ICD-10 will impact you, then contact us right away. We will also be providing custom consulting, training and crosswalk mapping for a small fee. Please contact us if you have questions!

5 Things Physicians Need to Know About ICD-10

July 20, 2015 Posted on Categories ICD-10

The new ICD-10 requirements will be updated as of October 1, 2015, which will bring the current number of diagnostic codes from 14,500 to 69,700, an increase of 55,200 new codes.

This change will greatly impact your practice efficiency and billing revenue for several months. To minimize the impact, you should educate yourself and your staff today to make the transition smoother in October.

Check out this infographic about ICD-10, and feel free to call Bonafide for a customized ICD-10 analysis, plan and support.

 

5 Things Physicians Need to Know About ICD-10

 

1. More Codes

ICD-10 will bring the number of diagnostic codes from 14,500 to 69,700, an increase of 55,200 new codes. This massive increase is mainly due to individual codes being multiplied to increase the detail provided.download The Shack movie

 

2. Laterality Codes

Laterality is a major theme in the expansion of codes under ICD-10. For example, instead of simply coding for a cyst on the eyelid, under ICD-10 providers need to specify the location of the cyst: left, right or bilateral.

 

3. Anatomical Location Codes

In addition to laterality, providers will be required to specify detail in terms of location of an injury or condition. For example, an arm fracture will now need specific details such as which arm (left or right), precisely where on the arm, and additional anatomical location details.

 

4. Combination Codes

ICD-10 includes hundreds of combination codes that link symptoms, manifestations and/or complications with a diagnosis. For example, rheumatologists may document the relationship between two conditions using language such as “due to,” exacerbated by,” “with,” or “in” to demonstrate condition severity.

 

5. Encounter Type Codes

Providers will need to specify whether the encounter is initial (patient receives initial active treatment), subsequent (patient receives routine care during the healing or recovery phase) or sequela (patient receives treatment for complications or conditions that arise as a direct result of a condition).

 

 

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