October 1 draws ever-closer, meaning now is ICD-10 crunch time for many healthcare providers. At SNFs and other facilities where billers have become accustomed to working with a familiar and relatively limited code set, the change means a lot of studying is underway.
CMS has calmed the waters for Part B providers somewhat with its decision to delay denials based on errors in specificity until 2016, but uneasiness remains in many Part A billing offices. Research conducted by ABILITY has found that billing managers at SNFs report denials and “constantly changing CMS processes” as two of their biggest challenges—which means that ICD-10 represents a combination of headaches. Since billers already cite claim denials as a major issue, the risk of increased denials has many billers anxious about how their workloads will change, and how they can manage the added demands.
With the time facilities have left before they risk a significant increase in denials, many are now reviewing or implementing “safety net” systems—measures they can put in place in addition to ensuring that coding and billing staff are trained in ICD-10.
We’ve previously covered the importance of gathering baseline stats now, which will give providers the data they need to accurately gauge any change in denial rates. Many SNFs are also finding that software that automates Medicare processes is helping in their ICD-10 preparations, since it can quickly alert billers to rejected claims and provide them an easy way to submit corrections.
CMS’s grace period announcement has signaled that another postponement of implementation almost certainly won’t happen. Between now and October 1, SNFs have a vital window of time to put their safety nets in place.