Becker's ASC Review

9 ASC Management ANTICIPATE CHANGE. WE DO. 636.273.6711 | www.nationalASCbilling.com The ASC Revenue Cycle. It's all we do. It's all we think about. And it shows. Hospital Review 150 Great Places to Work in Healthcare 2015 2 0 1 5 If you're reading this, the world didn't end on Oct. 1. As expected, ICD-10 caused administrative head- aches for healthcare providers across the United States. is was expected to be especially true for small practices and hospitals that were caught unprepared for the magnitude of transitioning to the 10th version of the International Classifica- tion of Diseases, now required by the U.S. Centers for Medicare and Medicaid Services for all Health Insurance Portability and Accountability Act- compliant healthcare providers. Even for the best-prepared ambulatory surgery centers and other providers that spent months updating their systems, training staff and run- ning drills, disruptions will remain inevitable into 2016. Aer all, this is the first coding switch in more than three decades, and business office staff — many of whom are too young to remem- ber the switch to ICD-9 — now have to contend with about 50,000 additional codes. e finan- cial stakes also are higher today, as the business of healthcare continues to change dramatically — and will continue to do so. What was once a simple coding mistake can now cause serious fi- nancial disruptions to a provider, especially when high-dollar surgical cases are involved. Federal healthcare regulators have recognized these challenges. In July, CMS announced it would provide the medical community with a temporary coding error reprieve for the first 12 months aer the Oct. 1 deadline, provided that the appropriate family code is used. With private payers not is- suing similar guidance, however, providers must remain vigilant in reducing errors, ensuring com- pliance and maximize reimbursements, especially in these six areas: Payers In the run-up to Oct. 1, many large payers appeared to have made a significant push to ensure the nec- essary ICD-10 updates were in place — or at least planned to do so. According to a Workgroup for Electronic Data Interchange survey release July 30, "nearly three-quarters have begun or completed external testing, representing a significant increase from one-half in the February survey." Specifically, an overwhelming majority of payers — seven out of eight — reported that their ICD-10-re- lated internal business process design and develop- ment is "complete or nearly complete." More than 80 percent of the payers interviewed for the survey had started internal testing, and about 40 percent had completed this step, according to WEDI. ese impressive ICD-10 readiness efforts like- ly skewed primarily to larger payers that have big enough budgets to absorb such expensive preparation efforts. In WEDI's July survey, self- described unprepared payers cited "competing internal priorities," "provider readiness" and "un- certainty around further delays" as the top three reasons why their efforts have lagged. is dis- parity suggests that the most unprepared payers tended to be smaller organizations operating in less populated states, where the provider commu- nity, too, may have been caught flatfooted because of scant resources and ICD-10 education. It may be months, however, before definitive trend lines emerge answering the what, where and why certain stakeholders were or were not prepared. In the meantime, accounts receivable staff can play an enormous role in tracking on- going issues with payers, educating coders and After the Storm: ICD-10 Efforts to Continue After Fall Deadline By Jessica Edmiston, National Medical Billing Services, senior vice president, performance review, BS, CPC, CASCC, AHIMA-approved ICD-10-CM trainer

• Cover