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The ICD-10 medical coding implementation, as expected, has created across-the-board duress for physicians, payers, software vendors and any other provider of healthcare services requiring medical claims submissions. To demonstrate the complexity of the switch from ICD-9 to ICD-10, the former contained about 14,000 codes; ICD-10 has approximately 144,000 codes and more codes will be added for 2017. One method of overcoming this challenge to healthcare providers and facilities is to outsource their medical billing and collections as well as coding needs to a company like MGSI. Our dedicated team of medical coders quickly becomes familiar with the client’s coding processes and services. They work closely with each client to ensure high quality coding performances and regulations.
Apart from the increase in the amount of codes available, the ICD-10 medical coding transition has also provided challenges in A/R and denial management. The percentage of denials is expected to increase exponentially until the new system ‘beds- in’ between the provider generated coding and what the Payer systems can adjudicate. Beginning October 1, 2016, CMS has implemented a rule that states providers must code diagnosis to the highest specificity. This means no more unspecified coding. An example of this is ensuring that every diagnosis is as specific as possible; this includes laterality and etiology of the condition. The first time a patient is seen and prior to an ordered test result is received an unspecified code may be used, but the follow up appointment must contain the new specific diagnosis. There are other challenges as well. One of those challenges is billing for Medical Necessity; many codes that could be billed from ICD-9 may not work when converted to ICD10 for certain procedures. Many sections of the ICD-10 medical coding manual are expanded well past that of ICD-9. Although technology did play a major role in ensuring a smooth transition, there is a big manual effort involved as well. It is best to have an experienced and knowledgeable ICD-10 medical coding team to ensure proper coding practices.
Healthcare providers and facilities can prepare for the ICD-10 medical coding transition by outsourcing medical billing to a reliable and reputable medical billing company like MGSI. Here at MGSI we have a team of AAPC certified multi-specialty coders who have already completed the requisite certification for ICD-10 medical coding and have their proficiency certificates from AAPC. They also attend multiple continuing education events throughout the year and share what they have learned with all of our clients. This helps ensure that we are helping providers bring in the most money they can. MGSI provides a full-suite of revenue cycle management solutions and ICD-10 medical coding services.