Becker's ASC Review

29 Coding, Billing & Collections I n April, President Barack Obama signed into law the Protecting Access to Medicare Act of 2014, which provided another temporary sustainable growth patch and effectively derailed ICD-10 implementation for at least a year. Reactions ranged from relief to dismay, but regard- less ICD-10 will not go into effect this year and healthcare stakeholders are left to reevaluate their implementation plans. CMS issued a statement on the expectation that HHS would soon release a final interim rule requiring ICD-10 implementa- tion to take place Oct. 1, 2015. Tim Meakem, MD, medical director of ProVation Medical, describes documentation as one of the most important is- sues in ICD-10 preparation and walks through a step-by-step timeline for obtaining the documen- tation support needed to make the ICD-10 switch in an ambulatory surgery center. 1. Now. Review the ASC's preparation and assess what remains to be done. "It is likely that you will determine a need for a structured reporting system, but you may also need evidence to convince some of your physicians and nurses," says Dr. Meakem. 2. By November 2014. Examine possible solu- tions. If an ASC decides to acquire a structured reporting tool, look for: • Deep medical content • Ability to customize • Workflow structured around the delivery of care • Quality reporting capabilities • Ability to capture data for care improve- ment, marketing or payer negotiations Avoid elements such as: • Templates. These require the physician to know what details of documentation are re- quired for coding and reporting. • Coding pick lists. These should be electron- ically linked to the documentation recorded. 3. By January 2015. Commit to a solution, whether it is the purchase of a reporting tool or not. "Different ASCs have different timelines for purchase completion, and I allowed for two months to complete the approval process," says Dr. Meakem. "If your system takes longer, then extend accordingly." 4. By July 2015. Put the solution into prac- tice. "You will want to ensure that all is going as projected and also allow time to make any adjust- ments needed before the switch," says Dr. Meak- em. Train the center's staff and physicians to use the reporting tool and on the implementation plan's expectations. Conduct regular coding and documentation audits to ensure the demands of ICD-10 will be met. Test with payers as frequently as possible to identify any issues that need to be addressed. 6. October 2015. Complete the transition to ICD- 10. Another delay is possible, but depending on another delay will leave the center unprepared if the transition date is final. "ICD-10 is needed because we are out of codes for ICD-9," says Dr. Meakem. "Only the timing is uncertain, but ulti- mately it will happen." n From Now Until October 2015: The New ASC ICD-10 Implementation Timeline By Carrie Pallardy

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