RSNA: Get prepared for ICD-10

CHICAGO—After some highly publicized delays, ICD-10 codes will be implemented Oct. 1, 2015, and radiologists were once again urged to prepare for the switch during a Dec. 1 session at the annual meeting of the Radiological Society of North America (RSNA).

Denise Merlino, founder of Merlino Health Care Consulting, highlighted important steps providers can take now to save themselves headache in the coming months.

“Anyone billing Medicare and Medicaid needs to understand the changes,” Merlino said.

The switch from ICD-9 to ICD-10, Merlino said, is due to capacity. “Really, it’s because we want to be able to describe why the patient is coming in and we want to be able to data mine the codes and information at a much higher specificity, but the capacity isn’t there. We’ve run out of a number of codes.”

Moving from ICD-9, which currently has about 14,000 codes, the new system will include approximately 69,000 codes. Additionally, the structure of the codes will change. Moving from the three to five character codes under the previous system, ICD-10 will feature three to seven characters and a combination of alpha and numeric characters.

“It’s not as overwhelming as one would think,” she said. “It’s a different way of looking at your practice—a different snapshot.”

Merlino stressed the importance of documentation under the new system.

“It boils down to if you didn’t document it, I can’t code it and you’re not going to be paid for it,” she said. “It’s also a component of good care.”

Tips to help radiologists and administrators included:

  • Identifying their current system and the most commonly used codes under the previous system;
  • Communicating plans between providers, payers and vendors;
  • Budgeting time to learn the new system; and
  • Identifying potential changes to workflow and business processes.

Merlino said radiologists need to understand the new approaches to documentation and the levels of specificity the payers require. Additionally, understanding where they are in the transition processes is key.

“Are you ready? Have you begun to prepare? It’s important to know where you are right now and to take the necessary steps to be ready for that transition,” Merlino said.