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Life after ICD-10 at Great Lakes Eye Care

Like most of the healthcare industry, Allscripts spent years preparing for the ICD-10 transition, which occurred on Oct. 1, 2015. Our Allscripts Payerpath® team monitored our systems and claims closely, and as anticipated, we did not see any issues related to ICD-10 in the days after the transition. Our operations consultants reached out to Payerpath clients, including Shari Payne, CPC, Administrator for Great Lakes Eye Care (St. Joseph, Michigan, U.S.A.). On October 2, Payne responded with an email so enthusiastic, we just had to share: We had ZERO errors today. We had a full house of patients, we did not decrease the schedule at all, and did not have ONE SINGLE ERROR. WAY beyond my biggest hopes!…Thank you so much for including us in your end-to-end user training…..what a benefit to us. We are all dancing the dance of joy today! […]

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ICD-10 has arrived. Now what?

  • Jeff Goldstein, MD, MS FACHE
  • 10/06/2015

For most healthcare providers, October 1, 2015 did not signal falling leaves and cooler temperatures. They were focused on ICD-10, a reality which will significantly affect hospitals and physician practices now and well into the future. For those getting a late start At a recent assessment, I asked if the organization had educated staff, worked with vendors to verify, install and test ICD-10 upgrades, audited ICD-10 coding for accuracy, and sent test data from their billing system to their clearing house for payment testing. I also asked if there was any consideration for delegation of responsibilities to managers who would know best how to address these concerns. Unfortunately, even though the deadline was looming, each question was answered with “No.” Allscripts conducted a comprehensive onsite survey to identify key ICD-10 readiness deficiencies and, from this, developed a prioritized remediation program. […]

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ICD-10 readiness: Will your coders have enough information?

  • Jeff Goldstein, MD, MS FACHE
  • 07/14/2015

User documentation, education and governance remain the top three issues threatening ICD-10 readiness. But another, equally disturbing practice is emerging. Many hospitals and practices have opted to let coding staff select ICD-10 codes based upon physician documentation, placing key decisions in the hands of the coders instead of clinicians. In a recent Healthcare Informatics article, Dr. John Elion noted that certain ICD-10 PCS (procedure coding system) codes require a great degree of detail and granularity. The physician must explicitly detail a procedure and the circumstances associated with the event so that there is no ambiguity as to the correct code. The real concern is not missing information, it is that the physician’s description is not formatted to meet the requirements of ICD-10. When this happens, then it is up to the coder, or clinical documentation improvement (CDI) specialist, to either […]

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ICD-10: Tips for heading into the home stretch

Hospitals and physician practices have been discussing ICD-10 for many years. However, even with a one-year implementation delay, many of them are only now realizing that they are still not ready for the October 1 start date. In the past month, our ICD-10 consulting practice has received more inquiries for assistance than in the past calendar quarter. We expect this pace will continue well into the coming months leading up to October. A significant number of inquiries have come from organizations that have considered ICD-10 to be an IT or HIM issue. In fact, when looking at the scope within a hospital or practice that ICD-10 encompasses, there are more than a dozen areas that should be involved, such as revenue cycle and contingency planning. Ignoring any of these areas can have a detrimental effect on ICD-10 readiness. 3 most […]

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ICD-10 strategies: Document consistently, with the right amount of detail

  • Jeff Goldstein, MD, MS FACHE
  • 05/06/2015

ICD-10 is the largest mandate in U.S. healthcare history, and it will require diligent, comprehensive actions to be fully prepared for the transition. This is the fourth post in a four-part series that explores successful strategies in key areas of ICD-10 readiness: general approach, governance, education and standardization of documentation. “The pen is mightier than the sword,” is a famous line from Edward Bulwer-Lytton’s 1839 play, The Conspiracy. Fast-forward nearly two centuries, we substitute the keyboard for the pen, and the idea is nonetheless the same; documentation is the quintessential element that translates one’s thoughts and actions into a durable record of key events in health care. Unfortunately, the lack of uniform documentation is the Achilles’ heel for ICD-10 readiness across the entire industry. Concise, thorough and comprehensive documentation is not only essential, but it is the required basis for […]

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ICD-10 strategies: Educate everyone, early and often

  • Jeff Goldstein, MD, MS FACHE
  • 04/29/2015

ICD-10 is the largest mandate in U.S. healthcare history, and it will require diligent, comprehensive actions to be fully prepared for the transition. This is the third post in a four-part series that explores successful strategies in key areas of ICD-10 readiness: general approach, governance, education and standardization of documentation. When Allscripts conducts an ICD-10 readiness assessment, a major area of review is to evaluate the organization’s educational programs. All too often organizations provide education for just the clinical providers (i.e., physicians, nurse practitioners and coding staff). But in fact, ICD-10 education should extend across the entire organization, be it a hospital, office practice, home health agency or any entity involved in direct patient care. ICD-10 training for clinical staff has slowed to a halt With the one-year delay in ICD-10 implementation, nearly every organization I have been working with […]

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ICD-10 strategies: Lead a successful change with strong governance

  • Jeff Goldstein, MD, MS FACHE
  • 04/21/2015

ICD-10 is the largest mandate in U.S. healthcare history, and it will require diligent, comprehensive actions to be fully prepared for the transition. This is the second post in a four-part series that explores successful strategies in key areas of ICD-10 readiness: general approach, governance, education and standardization of documentation. For a project as vast and complex as ICD-10, a successful organization needs a strong governance structure assigned specifically to this endeavor. Setting up the governance structure Leadership needs to define the operational structure required for ICD-10 readiness. It’s essential to have an ICD-10 executive sponsor and an ICD-10 “Czar” responsible for maintaining the project on a steady and consistent path. Once leadership designates these roles, they need to communicate them throughout the organization. The next step is to establish an operational committee with representation from the key areas affected […]

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ICD-10 strategies: Use this time wisely

ICD-10 is the largest mandate in U.S. healthcare history, and it will require diligent, comprehensive actions to be fully prepared for the transition. This is the first post in a four-part series that explores successful strategies in key areas of ICD-10 readiness: general approach, governance, education and standardization of documentation. Benjamin Franklin once wrote, “…nothing in this world is certain except death and taxes.” Most of us in the healthcare industry agree it’s time to add ICD-10 to this list.  On October 1, 2015, the United States will join 25 other countries in using ICD-10, the version that has been the standard for coding diseases, findings, medical complaints, causes and conditions of illness and injury since 1995. When CMS announced last year that it would delay ICD-10 until 2015, the healthcare industry breathed a collective sigh of relief. Unfortunately, much […]

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How much will ICD-10 implementation really cost?

Converting to ICD-10 is the largest healthcare mandate in U.S. history, and it comes at a price. Early estimates suggest small physician practices could pay $83,290 for the transition. But, as reported in EHR Intelligence, a recent study in the Journal of AHIMA paints a more hopeful picture. Based on new data about available solutions, authors estimate the cost for a typical small physician practice to be somewhere between $1,960 and $5,900. So, depending on who you talk to, it can cost anywhere from $1,950 to $83,290. Anyone involved with ICD-10 implementations understands it’s the project’s complexity that makes it difficult to estimate cost. Where are the biggest discrepancies? There are a few areas in which these studies differ: 1. Training Researchers who expect lower costs maintain that there are more ICD-10 training options available to clinicians today, including more […]

In response to evolving government regulations, physician practices are busy balancing technology requirements, reinventing workflows and improving communications across care settings. Facing these demands causes a lot of fatigue among clients. We want to support them, especially as they attest for Meaningful Use and prepare for ICD-10. What clients are telling us they need Several months ago, we formed a business unit to focus on professional practices. We wanted to offer a healthy core solution portfolio, help clients connect with communities through dbMotion, and enable them to manage revenue. To achieve these goals, we’re listening closely to clients. Their advice helped shape six key imperatives for my team: 1. Improve services, support and product usability. We now offer project management services. Our support offers client advocates to work regionally to improve our responsiveness to questions and concerns. 2. Bring new solutions to […]