Is your EMR Ready for ICD-10? Are you Ready for ICD-10?

Understanding the two questions is extremely important. Let me repeat:

  • Is your EMR Ready for ICD-10?
  • Are you Ready for ICD-10?

In order to succeed, both must be ready and work in unison. If either one is not, you are set for failure.

Popular misconception is, 'my vendor is ready for ICD-10, so I don't have to do anything.'

In a recent article in the Medical Economics, 'ICD-10 Countdown: How your practice can get ready', Michael F. Arrigo, CPHIT, CPEMR managing partner of No World Borders, a healthcare management and information technology consulting firm advises practices to view their EHR vendor as a partner, but not to assume the vendor alone will make them ICD-10 compliant.

“They can’t do it automatically by just upgrading your software and, in the end, they are not responsible for the healthcare providers’ compliance with ICD-10, the provider is,” he says. “At its core, ICD-10 is really about documenting the patient’s condition properly and the physician is the only professional licensed to diagnose, so they have to do a really good job documenting.”

Steps at the Practice

Not just the billing staff, every employee of the clinic must be trained, with the billing staff taking a leadership role. Ideally, everyone should take some formal courses. American Academy of Professional Coders (AAPC), the American Health Information Management Association (AHIMA) and the American Medical Association offer such courses.

From the billing and coding perspective, your challenge is going to be working with insurance companies. I read a very good interview of Dr. Scott W. Tranhaile, MD about his clinic's preparation. That may be an extreme case but shows you cannot take education and preparation lightly.

What about EMR?

EMR Vendor has two parts to their responsibility at the very minimum.

  1. They must be ready to submit ICD-10 codes to the clearing house and that testing must start if it has not started already to ensure everything would transmit correctly.
  2. It must allow easy modification to your templates and superbills.

A good System must make the overall workflow of the Practice as smooth as possible for you to document the patient encounter efficiently.

Can an EMR automate ICD-10 for you?

I recently read an interview of a new vendor that claims they can 'read' your notes and recommend appropriate ICD-10 codes. Really? I do not think technology has the level of 'artificial intelligence' to do that. And even if it did, do you really want to trust software to do coding for you?

Every practice must go through this educational process. What would happen if you get audited? An educated practice can breeze through such audits, versus saying, 'my software picked the codes'.