AAPC Conference News

Coders Balance Disappointments, Optimism at AAPC

By Deborah Robb, BSHA, CPC

Payers and coders are ready. Where’s the ICD-10 disconnect?

Numerous physician practice managers, coders, billers, and documentation professionals recently filled Gaylord Opryland in Nashville, Tennessee, to attend AAPC’s 22nd annual national conference, HEALTHCON. From lunch lines to keynote sessions, ICD-10’s delay was the focus of much shock and disappointment.

Speakers effectively wove the ICD-10 delay into their sessions by identifying key areas for continued focus and providing tips on how to maintain momentum. “Keep calm and code on” was the message from AAPC leadership. The association also received a round of applause for its offer of no-charge refresher webinars in 2015 for members who had already purchased the association’s ICD-10 training curriculum.

Perhaps the most insightful comments came from Tuesday morning’s opening session. A panel of industry experts concurred that the ICD-10 implementation delay didn’t occur because health care wasn’t ready; There were deep political reasons. The panel encouraged a packed audience to keep moving forward with ICD-10, take advantage of the additional time to prepare, and focus on reducing known implementation risks (eg, IT system readiness, payer end-to-end testing, physician documentation).

ICD-10: A View From the Industry
Simple mistakes were the most commonly identified problem during ICD-10 testing, according to Angela Boynton from UnitedHealth Group. One example was confusing the number 1 with the letter I and zero for the letter O in codes. She also reiterated that payers will continue to target unspecified codes for denial in ICD-10.

During this panel session, speakers encouraged attendees to use the additional time to ensure adequate planning and resources for ICD-10 testing and to push all their payers to test. This especially is true for physician practices, where one size doesn’t fit all. If payers refuse to test, attendees were told to ask payers for positive testing results with “like” providers, those similar in size, specialty, and geographical area. Whenever asked, coders commented that they were ready for ICD-10 and prepared to make the change.

Where’s the Disconnect?
Payers, including the opening keynote by Bill Gracey, CEO of BlueCross BlueShield Tennessee, also stated they were ready. Most of those in attendance already had upgraded IT systems, trained coders, and begun working with physicians to improve clinical documentation.

A recent webinar survey conducted by the Deloitte Center for Health Solutions indicated that 79% of the health care stakeholders questioned wanted to comply with ICD-10 by October 1, 2014. The providers with whom I spoke weren’t happy about the delay and wanted ICD-10 implemented this year. And while nobody was willing to wager a bet, the general consensus was that October 1, 2015, likely will become the new go-live date for ICD-10.

Time to Reach Out
With many already prepared for ICD-10 and opposed to the latest delay, now is the time to turn attention to those who presumably weren’t ready: small physician practices.

Many small physician practices with which I spoke were waiting until the last minute to prepare for ICD-10. Reactions from these practice administrators, physicians, and coders were mixed. Speaker tips to engage this lost segment of the provider population included the following:

• Engage physicians with a new approach.
• Embed ICD-10 physician education in another initiative, such as quality measures or quality improvement.
• Make ICD-10 documentation improvement a game; turn it into a competition at group practices.
• Reach out to payers for testing (as mentioned above).
• Budget for 2015 payment delays with cash reserves and set asides.

Restrategize, Rethink, Replan.
By the conclusion of HEALTHCON, most attendees were ready to face a new ICD-10 reality. They were focused on retargeting training efforts for coders and replanning clinical documentation improvement programs for physicians. They also were better prepared to conduct end-to-end testing with payers and have deeper ICD-10 conversations with their technology vendors.

In the end, practice makes perfect—and we all have at least one more year to practice.

— Deborah Robb, BSHA, CPC, is an AHIMA-approved ICD-10-CM trainer and director of physician services for TrustHCS.