Providers Guide For
ICD-10 Training

What are some Free ICD-10 Training Options Out there?

• CureMD, a leading EHR Practice Management and Medical Billing company is offering an open for all, free ICD-10 training for Physicians to educate providers on ICD-10. This training will cover ICD-10 fundamentals, conventions, coding and documentation strategies before dwelling in to specialty specific training.

• Some Insurance companies have gotten together as “Coalition for ICD-10” and are offering free specialty specific webinars to providers every Thursday.

• CMS training tools are available on line.

How much Time will be required for training?

There is no specific time duration for the training, the more it’s done, the better. However given the urgency of time The Medical Group Management Association suggests that the clinical staff should be trained for at least 16 to 24 hours whereas the coding staff should be trained for at least 40 to 60 hours.
All the rest, should be given a brief overview of ICD-10, how it will impact their respective roles and any changes in the EHR applications for ICD-10 that will affect them.

Who requires what level of ICD-10 training?

The entire practice will be affected and each person would require some level of training depending upon their role. This can be divided into the following:

• Basic Level : Required by the front desk staff

• Advanced Level : Required by the nurses and other office staff

• Expert Level : Required by physicians, auditors and Coders

Front desk staff

Healthcare delivery process starts from the front desk employees. Post ICD-10, given its extreme specificity, the responsibility of front desk employees will increase by a huge amount.

Now with the implementation of ICD-10, the entire system would undergo various upgrades and changes. Policies would have to be revised complying with HIPAA. Changes would occur in workflows, forms etc and these changes would have an impact on the patient-provider encounter.

These potential problems can be subsided by training the front line staff in following areas:

• Create awareness among your staff on what ICD-10 entails and how it’s the emergent need of the healthcare industry

• Brush-up their communication skills in order to handle patient complaints in a welcoming and timely manner

• Train them through role playing by presenting various patient conditions and ask them to respond accordingly

• Specify the patient conditions where they lack specific details.

• They need to be trained in knowing all the changes which ICD-10 entails, namely changes in system software, workflows, insurance plans, forms, technology used etc.

• Train them in getting in-depth patient medical history For e.g. they need to know the medical background history of the patient, how and precisely when a particular injury was caused, various symptoms and signs of a particular disease, involvement of third parties etc.

• They need to be vigilant and persuasive enough to ask the right questions and get the right cues.

• They must be empowered enough to explain the patients why certain claims have denied.

Providers

As a provider, the first thing to understand is that there will be an intense need for increased specificity within documentation once ICD-10 is in place. You will need proper training to learn how to adjust your documentation so that it meets these new requirements.

Read: How to Master ICD-10 documentation in 10 days

You will most likely also need training on any systems changes, especially if you have recently switched EHR systems. Please get in touch with your vendors to find out how they will accommodate your transition process.

You will also need to do the following:

• Identify all current work processes that are using the old ICD-9 codes. These will be things like encounter forms and superbills, clinical documentation, EHR and practice management systems, quality reporting protocols, and contracts.

• Create a cheat sheet with all of your most used codes if you have to.

• Speak with your current practice management system vendor to see if your contract includes upgrades as far as your agreement.

• You’ll next want to be in touch with all of your clearinghouses, payers and billing services to discuss implementation plans and set a date to test the systems.

• Determine how much training your staff will need and specifically identify the office staff who are responsible for coding so you can focus on staff that needs the training the most.

• Make sure you’ve budgeted for all of the time and costs related to the ICD-10 transition. This should include things like expenses for training, software updates and system changes.

Billers

The question haunting every biller these days is How to train for ICD-10 codes? Since now they would have to deal with a much larger code set. Billers must understand all of the new payer policies under ICD-10 and the entire billing department will need to be trained on these policies as well as any new procedures.

To start off, you will need to reinforce good coding Practice

ICD-10-CM and ICD-9-CM are similar in format, structure and organization. However, they differ in a lot of ways and coders must resist using shortcuts developed for ICD-9-CM.

Read: The Elusive 7th Character in ICD-10 , The Appropriate Use of Unspecified Codes in ICD-10

Every coder’s preparatory training for ICD-10 -- whether they are using a code book or software application --, should include a refresher covering the following concepts:

• Basic coding conventions

• General coding rules

• Instruction on the organization and format of index and tabular listing

• A step-by-step process for referencing main terms in the index and finding codes in the tabular list

• Importance of reading (and following) inclusion and exclusion notes

• Review of how to apply rules concerning combination codes

• Instruction about the use of additional codes and sequencing

• Coders should follow the “by the book” coding process in their normal workday to reinforce good habits and make it routine by the time they begin using ICD-10-CM

Watch: Basic coding concept and ICD-1O Conventions

They will also have to:

• Become familiar with all system upgrades.

• Identify the current ICD-10 codes used the most and put them in order of frequency.

• Once identified, make sure current documentation supports them.

• Learn the new codes most relevant to your provider as well as the specific anatomical relationship each represents.

• Once you’ve completed this process for the most frequently used codes, move on to other specialized codes that pertain to clientele that will also be a part of your daily routine.

• Notify the practitioner of the specific documentation that’s missing from current patient records.

• Perform a few test transactions with payers and clearinghouses using the new ICD-10 codes. Check to see when they will begin testing and which days they have those tests scheduled.

• Learn to fully understand how money is working in your practice so once ICD-10 has been implemented you’ll know if it’s causing any problems. You’ll specifically want to evaluate your payer mix, determine what’s typical for your accounts receivable cycle, and examine your denied claims.

Practice Managers

Practice managers have to oversee the ICD-10 implementations across all other departments.

• They will also be responsible for revising any policy or procedure associated with tracking, disease management, or diagnosis codes.

• They will need to make sure that all payer and vendor contracts are evaluated and updated

• They need to create budgets to reflect the need for new contracts, paperwork and software changes.

• They would have to come up with a training plan since everyone on staff will need a certain amount of training that is the most relevant to their role.

• They must be in charge of ensuring there is strong and clear communication between all departments.

• CureMD provides a detailed Project plan for a smooth ICD-10 transition, so practice managers wouldn’t have to worry about all the responsibility.
  

How to Practice for ICD-10?

Crosswalks and general equivalence mapping tools are a good starting point for familiarizing yourself with the new code set without having to be overwhelmed with so many new codes. These tools provide forward and backward mapping facilities for practices to easily practice on ICD-10. Using them in your EHR application will also help you to adjust to the new workflow. Make sure your vendor has activated ICD-10 in your EHR so that you can go ahead and practice before Oct 1.
Here is a good process to follows

• At a minimum train for ICD-10 fundamentals, conventions, guidelines, how to find the right code in the tabular list and the documentation requirements for your most common codes.

• One you have undergone these trainings practice managers or billers should create cheat sheets for most common codes to be used by providers and coders.

Download: Top 20 specialty specific ICD-10 codes.

• Use the GEMs tool in your EHR to map to ICD-10 using the information provided to you. Try this on a few sample provider documentation to see if the provider is providing sufficient documentation to the coder to code to the highest specificity possible. If not revisit your provider documentation to identify gaps and repeat this step again.

• If there is no improvement in the process, identify the gaps and consider drilling down into greater training for improvement.

How much would it cost?

Front desk staff

Since they require basic training it would require a day or two at max to help them understand the basics and code structure involved. These could range between $250-$299 per employee

Billers

Billers would require training for a day or two at max. Training costs would range between $250-$299/biller. This training would entail the basics of ICD-10 structure, its impact and how to cope with it. Costs for coding manuals might not be included in these costs.

Physicians

Costs for training physicians could go as much as $500 per physician. However CureMD’s physician training program is provided absolutely free of cost with detail FAQ sessions.

Coders

Training costs would vary depending upon the number of people involved. Our advice is to keep a budget of at least $695-$1,200 per coder for a 48 hours training. These costs would cover the training manuals required and other guidelines. Training coders for anatomical laterality and human physiology could cost additional $1500.

Final considerations

Make sure to reserve extra cash or establish an alternate line of credit to keep up with the training and implementing costs. Since in the initial phases, practices would experience revenue losses given ICD-10 specificity.

Lastly remember that training is never enough, it’s an ongoing process. One learns with patience and perseverance. Adequate training is highly imperative in order to uphold your staff’s productivity and ensure a smooth transition.

For general updates and expert advice – CureMD Road to ICD-10 Series