Anesthesiologists and ICD-10

Conquering the ICD-10 coding transition to maximize reimbursement for anesthesia services will take some effort, but it should certainly pay off in terms of increased revenue, less paperwork and improved overall clinical efficiency.

While full implementation of the new coding system is still a year away, a lot needs to happen before then. CMS suggests that hospitals and physicians focus on communication throughout the last few months of 2013 and begin more comprehensive training in 2014.

Anesthesiologists will want to take advantage of the available training opportunities regarding specific Procedure Coding System (ICD-10-PCS) documentation requirements and Clinical Modification (ICD-10-CM) changes.

The 10th revision of the International Classification of Diseases (ICD) system will use more than 14,400 distinct codes. The ICD-10-PCS will use more than 76,000. And, to the dismay of many, the new codes will not simply be an extension of the old ICD-9 codes. The new codes will be as many as seven characters long to provide more specificity than the current codes, which have between three and five characters. Some of these new codes are painstakingly specific, such as to describe injuries sustained through a collision with a turtle.

Because ICD-10 codes will be different than the 9th generation codes, it is vital for anesthesiologists to become familiar with them ahead of time. It’s also important for physicians to understand that selecting the proper ICD-10 codes will require more specifics in terms of anatomy and the purpose of the visit, whether it be initial treatment or follow-up care. This will almost certainly require more collaboration between anesthesiologists, surgeons, and other hospital staff.

Even when working with an expert billing department, the burden for coding completeness and accuracy will remain on the doctor. Coders won’t simply be able to manufacture ICD-10 codes without having all of the necessary building blocks of information in the chart. In the case of ICD-9, without complete information, coders could default to a “not otherwise specified” (NOS) catchall code. In the future, NOS payments will most likely be reduced or outright denied.

Consequently, making sure that all clinical and billing information is accurate and complete up front will save time and preempt any requests for additional data for physicians.

This slowdown in coding will likely decrease physician productivity, which could definitely impact cash flow. Anesthesiologists should be prepared for this kind of unstable financial situation and possibly consider establishing a line of credit before the transition.

Waiting until ICD-10 is implemented to study and practice with the new system could result in permanent loss of revenue if one isn’t able to file claims correctly within the payors’ timely filing limits.

While it may still be a bit early for anesthesiologists to train for ICD-10 in depth, it’s not too early to prepare office systems for the new codes. Since ICD-10 codes will require more information, anesthesiologists can benefit from starting to document their services and procedures now as if claims were being submitted with ICD-10 codes. That way, adequate documentation will be second nature when October 2014 rolls around.

MBA Medical’s expert billers are prepared to help you transition to ICD-10 smoothly and maximize your practice’s revenue. If you’re interested in outsourcing billing for anesthesia, contact us today!