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ICD-10: Views from a Practice Manager

by Donna Masucci, RN, office manager

As a practice manager who oversees a staff of nine including three clinicians, one billing supervisor, one lab tech and one medical home care coordinator, I clearly understand how a health care regulation like ICD-10 can stir up trepidation, and lead to the obvious questions: How will this affect care delivery and my practice’s bottom line?

In speaking with our providers about ICD-10, these concerns have surfaced. While they feel ICD-10 will provide a more descriptive documentation of diagnoses, they also wonder if clearinghouses and payers will have their systems configured to accept ICD-10 and avoid improperly denying submitted claims. Dr. Peter Masucci, my husband and principal physician of our family-owned practice, is most concerned with being able to identify a proper ICD-10 diagnosis code within a manageable time frame for each patient visit.

Hesitations aside, the main focus now needs to be on successfully making it through the ICD-10 transition with as little disruption to the day-to-day of your practice as possible. So, here is what I’m doing —and planning to do — as a practice manager to ensure we’re ready for October 1, 2014.

What We’re Doing Today

I recommend that all practices start small and get your ducks in a row before tackling more of the specific technological and procedural aspects of a transition as large as ICD-10. For our practice, we began by identifying an ICD-10 team. This includes Dr. Masucci, me, and our billing supervisor. Among the three of us, we will create the roadmap for educating, training, testing and implementing ICD-10 at our practice.

As part of this roadmap, one of the first actions is to upgrade the software for our in-house lab information system (LIS). We were notified by our LIS vendor that this upgrade would be a requirement in order to be ICD-10-compliant—this is not the case with our athenahealth practice management services as their technology platform does not require or demand our practice to manage software upgrades. And as part of our partnership with athenahealth, their service teams helped us connect with our LIS vendor to ensure not only a smooth transition without lab downtime. This kind of co-partnering support is unprecedented in the industry, and we value and depend on it—especially through times like these.

At 12 Months Out

Once this LIS upgrade is successfully completed, we’ll begin seeking out the best tools and programs to educate our office staff for the larger ICD-10 implementation for the clinical side of our practice. With the additional documentation and coding requirements inherent in ICD-10, I will be researching tools and seminars to help train our providers and support staff. I’ve already begun leveraging resources from the American Academy of Pediatrics organization so we can adequately prepare for and navigate the ICD-10 training process.

Having a close relationship with our electronic health record (EHR) vendor is crucial to our success: We’re heavily relying on athenahealth to guide and educate us throughout the transition ICD-10. And I rest easy knowing they are guaranteeing ICD-10 success by putting their own revenue on the line, and protecting clients against any significant cash flow interruptions as a result of the transition.

Knowledge is Power

Having the resources and support of our EHR vendor, peers and physician group organization provides that power—and, frankly, gives me confidence—that we will ably survive the ICD-10 transition, while continuing to care for our patients at the highest level possible.

Donna Masucci, RN, is an athenahealth client and office manager for Peter E Masucci, MD, PC, based in Everett, Massachusetts.

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