Coding for injuries such as fractures is among the biggest challenges facing Diagnostic Radiologists as ICD-9 transitions to ICD-10 by Oct. 1, 2014. To give you an idea of the shift, compare all codes related to fractures of the radius: ICD-9 included 32 codes. ICD-10-CM has 1,731.
The jump from 16,000 codes in ICD-9 to 68,000 codes in ICD-10-CM is resulting from a greater amount of information that’s required about the acuity of the patient and correlating disease process. Fracture codes will be much more detailed, including which limb it is, the fracture displaced or non-displaced, for example. They will have five classifications rather than just open or closed.
Example:
ICD-9-CM code: 813:52 other open fracture of distal end of radius (alone)
Vs.
ICD-10-CM code: S52.571M Other intra articular fracture of lower end of right radius, subsequent encounter for open fracture type I or II with non-union
Your level of medical record documentation across all aspects of service will also increase significantly. These changes and others are expected to impact office procedures and affect every aspect of your business operations including Diagnostic Radiology revenue cycle management.
Now is the time for your Diagnostic Radiology practice to implement clinical documentation improvements found during compliance audits. In addition, it’s the time to ensure you are getting good strong clinical information from other areas of the hospital, such as the Emergency Room.
At this stage of preparedness, it’s also important to understand how best to mitigate the risks and challenges for your practice that accompany this transition, and to what degree this transition can fully benefit, and grow, your medical practice billing and coding.
Risks/challenges include:
- More detailed medical records
- More time to translate/interpret by coders
- Increase provider queries by coders
- Increased delays in authorizations
- Increased claim rejections
- More time to research/resolve reimbursement issues
- Increase queries for documentation by facilities
- Same notes used in facility and office
Outsourcing your Diagnostic Radiology coding, billing and collections, when you have the right partner, gives you the industry insider expertise your team needs to ensure your risk is minimized and your revenue is maximized.
During the conversion, said to be the most significant overhaul of the medical coding system since computers were introduced, your practice requires a physician revenue cycle management team with the expertise and a full cadre of support and resources especially designed to prepare your team to:
- Organize the effort
- Analyze the impact
- Contact the vendors
- Budget for costs
- Implement software and systems upgrades
- Conduct internal testing
- Train staffs
- Conduct external testing of transactions
- Keep revenue flowing
- Maximize revenue stream
It takes the special expertise of an industry insider in Diagnostic Radiology revenue cycle management to understand how to most effectively transition to ICD-10. For more than 25 years, revMD.com has been the leader in meeting the unique needs and billing nuances of hospital-based Diagnostic Radiology physician groups. Dedication to follow through gets results because revMD.com deftly navigates changes in medical practice coding and collections regulations to keep practices current.
Additionally, revMD.com doesn’t just focus on the higher RVUs of interventional procedures, CTs, MRIs and ultrasounds, but rather collects on each CPT code, such as minimally reimbursed codes like single view and two view X-rays (71010 and 71020).
revMD.com is the results-proven alternative for medical practice revenue cycle management, with a niche specialization in Diagnostic Radiology billing and coding that generates unprecedented results and builds profitable medical practices. Leveraging a history of industry wide success spanning 25 years, revMD.com partners with medical practices throughout the U.S. to optimize revenue for hospital based and practice based physicians. For more information, visit www.revmd.com.