End of ICD-10 grace period takes toll on smaller practices

Monday, December 5th, 2016

While the transition to ICD-10 impacted all healthcare providers, it may have taken a larger toll on smaller practices. This is becoming clearer following the end of the ICD-10 grace period last month.

Speaking to Health Data Management, Primeau Consulting Group's president of revenue cycle consultancy, Debi Primeau, outlined why smaller physician groups and individual practices may be struggling more than others:

"If they are hurried and don't really understand codes, these practices may be choosing unspecified codes, and because many of these organizations have not yet performed coding audits, they really don't know if there is a problem or not," Primeau said. "What we're talking about is identifying opportunities where you can focus on denial prevention versus denial management."

As of October 1 this year, the Centers for Medicare and Medicaid Services reported 1,974 additions, 311 deletions and 425 revisions to diagnosis codes. Meanwhile, for procedure codes, there were 3,827 additions, 12 deletions and 421 revisions.

Industry experts are encouraging healthcare providers to conduct thorough audits of their own to prevent increases in denials.

"Conduct thorough audits to prevent increases in denials."

Lack of tools leaves smaller practices vulnerable
Another area where smaller healthcare providers must be vigilant is the tools they use. As reported by TechTarget, some small practices were left exposed to ICD-10 changes due to a lack of proper tools, not a failure to familiarize themselves with code changes. Medical professionals using vendors that do not stay in compliance with code changes simply won't be able to keep up.

"A lot of the ability to be ready is out of the hands of the physicians themselves," Robert Tennant, senior policy advisor of government affairs at the Medical Group Management Association, told TechTarget. "[A doctor] may have gone through countless hours of training, he may be well versed on the codes, but if he's unable to include the code in his software to allow it to be included in the claim going to the insurance company, then they're out of luck."

Without routine product updates, physicians leave themselves vulnerable. Fortunately, clinical interface terminology provided by Intelligent Medical Objects makes it easy to future-proof against code changes. Products like IMO 2.0 ETP take a doctor-first approach to help physicians easily find and utilize proper codes using the language they understand. With automatic updates and improved dictionary maintenance, practices of all sizes can ensure fast, easy and clinically accurate documentation while avoiding terminology searches for outdated concepts.

What's more, IMO allows practices to spot potential gaps between dictionaries and clinical quality measures, making it easier to deliver high-quality care.

Meanwhile, IMO Anywhere provides access to IMO's best-in-class problem and diagnosis terminology from any web-enabled device. Physicians can easily access IMO's drill-down functionality to navigate ICD-10 codes at point of care.

IMO clinical terminology is the most widely used in the industry - find out why.