CMS has recently agreed to allow providers less coding specificity and not rejecting claims which are the result of coding errors alone for the duration of the first year of the ICD-10 coding system. Along with this safety net, CMS has also stated that they will be offering additional resources for education and training. Most of these tools are available as of now but do they really help providers?
The innovative tools announced by the agency are checklists, timelines and links associated with training units. They explain the terms and conditions of the newly adopted policies that are to be in effect during transition. Other than this, however, there isn’t anything new. A greater percentage of these tools were available before as well. Navicure’s vice president of strategic planning and regulatory compliance at Duluth, Ken Bradley, said that the resources could be helpful for practices that were just getting started because having elaborate planning tools could help providers make sure they’ve covered everything.
It is apparent that many of the practices that have had months to prepare are still facing difficulties. They claim that the available material isn’t helpful. Joan Ross, a practice manager at a large orthopedic practice, says that she hasn’t learned anything from CMS and the information she did get was confusing. Providers like Ross concern themselves with minute details, for instance, how would we go about managing split billing if a patient is admitted into the hospital on a certain day but has surgery a few days later.
The answers to such detailed questions are not easy to come across. With the extensive amount of information that is available, most providers are having trouble finding out what they need to know. The fact remains – providers are busy people and they simply do not have time to surf the CMS website looking for answers. In such scenarios, providers like Ross depend on their EHR vendors to guide them.
Most providers believe that the safety net CMS has offered won’t be of much help either. Ross says that a year of dual coding would be more helpful. Providers understand that the adaption of the new codes is not only necessary but will be helpful in the long run; however, the entire industry is not prepared to hop into it all at once. Moreover, Ross is of the opinion that some of the claims will be denied due to bad codes regardless of CMSs’ proclamation. The reason for this is that it’s basically computers communicating with other computers.
Despite the outcome and perceptions of providers, CMS is putting effort into making the transition smooth. It is not clear if that effort will ultimately be helpful or not.