ICD-10: Is Your Home Health or Hospice Ready?

It was not but a year ago when the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. No. 113-93) was enacted, which stated that ICD-10 could not begin prior to October 1, 2015. While many in the industry thought another delay might sneak itself into the SGR fix bill that was being worked on in the capital, this week the Senate endorsed the House bill to scrap the sustainable growth rate (SGR) formula used to set physicians’ Medicare rates and it did not include another ICD-10 delay.

All Home Health and Hospice providers that have not already begun the process of preparing for and implementing ICD-10, should begin as soon as possible as it is mandated to begin 10/1/2015. As a provider you may be asking yourself what can you do to prepare. I recently spent time with Laresa Boyle, HEALTHCAREfirst’s Director of Coding Services, to help providers with that very question. Below are assessment questions that you can ask within your agency to help kick things off:

Which positions/people in your agency currently have any relationship with ICD-9 coding?

  • Consider all departments…it isn’t just your coders and clinicians
  • What is their current involvement with coding? This will help you determine who needs ICD-10 training and what level of training they need

Is your agency’s current ICD-9 coding process effective?

  • Are your clinicians adequately trained regarding OASIS C-1 completion and ICD-9 coding?
  • What tools are provided to the clinical staff to assist with this aspect of their job?
  • Who reviews the clinical documentation for coding and OASIS?

Who is responsible for preparing you agency for and leading it through the ICD-10 transition?

  • The implementation of ICD-10 will present many challenges and changes in the daily operations of your agency
  • Have realistic expectations
  • Be prepared for the worst and hope for the best

Additional documentation that can be helpful in your agency’s ICD-10 transition plan can be found on the CMS website.

HEALTHCAREfirst will continue to monitor ICD-10 and report any changes or new information as it comes available. Providers that use one of HEALTHCAREfirst’s software product lines have been sent information regarding ICD-10 preparedness.

HEALTHCAREfirst can help with your ICD-10 coding. For information about our outsourced coding services, click here.