Accurate ICD-10 Coding Is Critical To The Clinic’s Bottom Line

October 25, 2017

GE Healthcare’s Centricity Practice Solution, like all business-essential software, helps remove complexity from tasks that would otherwise be unmanageable. For one, the clinic’s EHR software must assist physicians and medical coders in the clinic with the correct choice of ICD-10 codes. With more than 68,000 options in the International Classification of Diseases database today—up from just 13,000 in the ICD-9 standard—the likelihood of human error is too high to proceed without automated assistance.

To provide just one example, “degenerative myopia with retinal detachment” has five ICD-10 codes assigned to it, not one. This granular level of detail helps describe the precise diagnosis. The good news here is we have Clearinghouse tools available in Centricity to help you manage the complexity of ICD-10 coding and maximize revenue.

Improving clinic workflows is another critical aspect in getting ICD-10 right the first time. Data is only as good as the inputs received, which squarely places the responsibility on the clinic’s physicians to make the accurate call at the point of care. You never want the clinic’s coder(s) to guess which code is correct after the fact and input the wrong code or series of codes. That will quickly make for an unnecessary billing logjam. The chain of communications from physician to coder to payer needs to be flawless, or payments will be denied or lost in the system.

“The idea is to minimize billing time, reimbursement time, get a clean claim and get money get faster and improve cash flow,” Denver Wade Harless, who works for the Sacred Heart Health System, told Healthcare Finance News. Harless believes “a lot of clinical legwork needs to be done to get more specific information from physicians.” Our take is, workflow improvements are always highly beneficial, but workflow realignments, in combination with added functionality in the EHR, produce the biggest wins for the clinic.

Four Keys To ICD-10 Coding Success

1) An awareness of the issue and a commitment to solve it
2) Physician training to help identify the right codes at the point of care
3) Customization and optimization of Centricity
4) Select clinic workflow improvements (determined on a case by case basis)

There’s no question that the challenges in value-based care, including keeping up on the latest developments in ICD-10, puts an extra onus on practice administrators and physicians. The complete solution includes hiring talented coders, internal training, process improvement, and software upgrades.

Our implementation team at Quatris Healthco is available to discuss your ICD-10 questions on a call that I am happy to set up fro you.

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