Getting Ready for ICD-10 with OfficeMate/ExamWRITER

checkmarkThe entire medical industry is aflutter with ICD-10 news, tips, dates, codes, documents, and even a funny comment or two about some of the new codes (W56.22xA – Struck by orca, initial encounter?!). But really, the information that you need most is answers to these two questions:

  • What are the exact things that I need to do to prepare for the October 1, 2015, cutover date?
  • What are the exact things that I need to do in order to bill using the new ICD-10 codes?

If you are using OfficeMate/ExamWRITER and plan to upgrade to version 12.0 so that you can bill ICD-10 codes, we have created a short checklist that will help guide you through the ICD-10 transition. It boils down to this:

Before you upgrade to version 12.0:

  1. Finalize all of your open exams in ExamWRITER.

After you upgrade to version 12.0:

  1. Ensure that you have set up your personal ExamWRITER preferences.
  2. Update any custom templates and clinical decision support templates that you created in ExamWRITER that contain ICD-9 codes.
  3. Ensure that your office location address is complete (i.e., mailing address and nine-digit ZIP code) in OfficeMate Administration.
  4. Determine when you want to begin submitting ICD-10 codes, if it’s not going to be on October 1, 2015.

Before the October 1, 2015, Cutover Deadline:

  1. Record all of your fee slips that are on hold in OfficeMate.
  2. Process all of your open insurance claims in OfficeMate.

After the October 1, 2015, Cutover Deadline:

  1. Document exams in ExamWRITER as you have always done, selecting eye lateralities and then diagnoses. Yes – it’s that easy!
  2. There is no step 2! ExamWRITER will automatically code your exams, based on your exam selections, and transfer the codes to OfficeMate fee slips.

Transitioning to using ICD-10 codes may sound daunting, but if you’re using OfficeMate/ExamWRITER 12.0, you are ready!

ICD-10 is a New Era

By Dr. Robert (Bob) Day, Jr., Broadway Eye Center, Garland, TXdr_bob_day_web

When I started learning ICD coding, my dad, Dr. Robert Day, Sr., was President of the American Optometric Association (AOA), and they had just published the first Current Optometric Information and Terminology (COIT) book in June 1974.  It was optometry’s first attempt to participate in the new medical trend of systematically classifying diseases.  Optometry was just beginning to become more than simply prescribing a pair of glasses to help patients realize improved vision.

Learning ICD-9 versus ICD-10 is very much like comparing learning multiplication tables to learning calculus.  I can’t remember a time when I didn’t know my multiplication tables, but I remember struggling to learn calculus all too well.  I probably learned multiplication in the second or third grade. It was a straightforward process where one problem produces only one answer.  For example, 2×2 can only equal 4—easy enough, right? Then you advance to calculus (particularly differential) where one problem can produce multiple possible answers.  The learning process is far more complex, and the answers, at least initially, are far less obvious. But it can be done; you just need to spend the time to identify your best resource and to understand your goal.

Even now, I calculate simple multiplication in my head, but for calculus I need the help of technology (a calculator) to do calculus.  Likewise, ICD-9 is committed to memory, but for ICD-10, I will depend on technology in the form of my electronic health record system to handle most of the ICD-10 coding.

Speculation abounds, but it’s reasonable to assume that ICD-10 will mark the end of the paper super-bill and coding from memory. Under ICD-10, the AOA’s Express Mapping Card alone is four pages with almost 300 codes.  ICD-10 is clearly more complex, and trying to manage it without the help of technology will drastically add time and expense to your coding.

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Will the Implementation of ICD-10 Interfere with Meaningful Use?

No, but…Michael_Opsteegh

The implementation of ICD-10 does not affect your meaningful use (MU)  calculations. While the compliance date for ICD-10 is October 1—well into your meaningful use reporting year—you will not see any impact on your MU calculations.

It seems strange to think that such a disruptive change as ICD-10 wouldn’t impact your MU attestation. The transition from ICD-9 to ICD-10 applies only to diagnosis codes in offices and outpatient settings. The MU core and menu set measures do not require specific diagnosis codes. Therefore, ICD-10 will not impact your MU calculations.

The clinical quality measures (CQMs), however, are very dependent upon the proper diagnosis codes being in place. Eyefinity has you covered in this regard. Our 2014 Edition CQMs will accept your ICD-9 and your ICD-10 codes. Even when you switch midway through your reporting period, your calculations will reflect both code bases.

Here’s the but…

There’s one small detail that you may need to address one time. You’ll need to add any ICD-10 codes  to your clinical decision support rules to ensure that your diagnosis still trigger the correct clinical decision alerts (Stage 1, core measure 10; Stage 2 core measure 6).

Sink or Swim with ICD-10; My story

dr_bob_day_webBy Dr. Robert (Bob) Day, Jr., Broadway Eye Center, Garland, TX

In our office, preparing for ICD-10 coding is similar to a life-boat drill….go over the basics and depend on the technology used by the boat captain to keep you from getting in the water over your head.

The Basics

To get started, I identified the resource that’s familiar and comfortable to me. In my case, it’s the American Optometric Association (AOA).

My staff and I viewed webinar recordings from AOA’s EyeLearn Webinar recordings.They were very interesting to watch, but like most continuing education lectures, I’m not likely to remember much of it.

We also chose the AOA’s 2015 ICD-10 Coding Bundle, for those times when we would need to look up specific codes. With our reference library in place, I consciously rejected all online websites that show conversion tables from ICD-9 to ICD-10. These websites only give unspecified eye codes, even though ICD-10 is based on which eye is being coded.

Finally, and in my opinion most importantly, I will depend on the technology of my Electronic Health Record software to take care of 95% of the coding for me.  I know that a few patients will present with strange problems (corneal injury to the right eye from a left elbow of a taller person during basketball practice on a Tuesday!) for which I will rely on my reference book. But for the most part, I will trust my EHR to steer me out of the undertow.

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ICD-10—We are in this together

Dane Laverty, Eyefinity.com Product Manager

dane_web

You’ve heard about the changes to expect when the industry transitions to ICD-10. You know that practices will be impacted, and must plan and prepare, but have you considered what needs to happen on the other end to keep the claims process moving?

Solution providers, clearinghouses, insurers, and CMS all must be prepared for ICD-10 before October 1, 2015 to accommodate services and claims when it begins. From every angle, the change to ICD-10 is a really big deal.

I’ve been working hard to ensure Eyefinity.com is prepared to handle the cutover to ICD-10 on October 1. Our team is wrapping up development and it’s come together really well. But what does this mean to you? According to the law, all payers must accept and process claims using only ICD-10 codes on October 1. It’s a hard and fast rule and date, with no exceptions.

You’ve probably used Eyefinity’s eClaim to submit claims to VSP. But did you know that you can use eClaim to submit claims to over a thousand other payers?

Eyefinity.com handles millions of claims each year, every one of which contains diagnosis codes. Suffice to say, the effort to coordinate changes in our systems while monitoring the status of all of the payers that eClaim submits to has kept me up at night, ensuring that it works efficiently and without problems. Eyefinity, VSP, and our partners have worked closely to ensure a seamless transition from ICD-9 to ICD-10, so that on October 1 Eyefinity will be ready to support you.

We’re taking a proactive approach to be sure that we’ll be ready for the change in plenty of time. Will you be ready, too? It may not be easy, but the key to success is taking the time to research and learn now.

ICD-10—Coming Soon to YOUR Practice

Michael_OpsteeghBy Michael Opsteegh, Sr. Technical Writer

Were you one of the many providers waiting to see if the ICD-10 compliance date would be postponed beyond 2015? Despite mounting efforts to delay ICD-10, members of Congress refused to include the delay in the “Cromnibus” bill passed in December. Failing to slip the delay into a massive spending bill may prove to be a fatal blow to the delay effort. ICD-10 will be required beginning October 1, 2015. Are you prepared?

For all of the hype around “the big change,” you may be surprised and pleased to find how easy it can be to manage—if you’ve prepared properly.

Preparation is Key
So, how does a busy provider prepare for such a change? Transitioning to ICD-10 can have a huge impact on reimbursements in the form of rejections for incorrect coding or additional time needed to properly code. Take heart—your experience doesn’t have to negative. Simply prepare.  Employ tools, like Eyefinity EHR or ExamWRITER, that will manage the conversion and coding for you. Our EHR products will take on the coding, step you through code selection, manage the transition from ICD-9 to ICD-10 based on service date.  If you want to see when your EHR will be ready, check out our ICD-10 resource page.

With preparation in mind, CMS has identified testing periods in 2015 to ensure that submitting claims using ICD-10 codes will be successful for providers, clearinghouses, and payers. Test groups for each period are limited, and applications must be submitted to be selected to participate. For more information, check out the CMS MLN Matters publication.

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New Year’s Resolution: Understand the Impact ICD-10 has on Your Practice Financials

Cristin_Hollis_webBy Cristin Hollis, Revenue Cycle Management Supervisor

With the New Year comes the realization that ICD-10 is only 10 months away. AHH! Did anyone else’s anxiety just spike? Have no fear! There is still time to plan and prepare for the change. My particular interest is on how ICD-10 may impact your practice financials.

Most change brings associated costs and ICD-10 is no different. You may have already factored in software conversions, training, coding education, and clearinghouse fees, but ICD-10 also has the potential to impact areas you may not have considered.

Here are some questions to think about:

  • How will ICD-10 impact your practice revenue?
  • How will ICD-10 affect your cash flow?
  • Will you need more staff to maintain your current day-to-day operations?

These are difficult questions and even more difficult to answer if you’re dependent on third parties during the transition. Still, you can take steps to prepare yourself for October 1.

Where to Begin
Your first step should be to leverage your current ICD-9 workflow and analyze your historical practice data. Knowing your historical claim volumes, reimbursements, and payer mix will give you a good indication of the impact to expect as a result of the transition to ICD-10.

What areas may be potentially affected?

  • Accounts receivable cycle
  • Cash flow
  • Provider reimbursements
  • Claims submissions
  • Payer processing turnaround

Prepare for delays or adjusted cash flow now to avoid hardships in October. And finally, make sure all doctors and staff are prepared. With proper preparation, additional staff and resources may not be necessary at all.

Do you have an ICD-10 question or topic on your mind? Let us know.