Are You Ready for ICD-10?

The time has come. ICD-10 is here. Your months and years of ICD-10 preparation will now be put to the test. It is time to stop anticipating ICD-10 and start tracking its impact on your revenue.

Across the country, hospital executives fear the effects of ICD-10 on their revenue, and for good reason. The Centers for Medicare and Medicaid Services (CMS) predicts that hospitals and health systems could see payments decline for up to two years after ICD-10 takes effect.

It doesn’t end there. CMS predicts that:

  • Denials could increase by 200%
  • Accounts receivables could rise to 40%
  • Claim error rates could grow 10%

But you don’t need to go it alone. Data analytics can shine a light on your ICD-10 efforts and help you approach it with confidence. Our advanced analytics enable you to measure, monitor, and benchmark the impact of ICD-10 so you can identify outliers, prevent denials, and protect your bottom line.

Follow these top five tips as you track your ICD-10 performance with data analytics:

Tip #1: Trend and benchmark CMI, unspecified code usage, and secondary diagnosis codes.

Let your data show you how your ICD-10 performance compares to your peers. Say 90% of your peers are coding for a particular secondary diagnosis code but you are not. Understand why that is and take steps to rectify the problem.

Tip #2: Reduce denials by identifying their trends and causes.

It’s a fact. Denials will increase after ICD-10 takes effect. But you can take control over them now, before they pose significant risk to your revenue. When you identify the trends and causes of documentation and coding denials, you can spot where your ICD-10 coding efforts may be going wrong and what you can do to help ensure your claims get paid.

Tip #3: Identify required specificity missing from physician documentation.

ICD-10 is all about specificity. Your physician documentation needs to be specific to make sure you are paid for the complexity of care you provide. Unlike some analytics solutions, our proprietary ICD-10 analysis can identify which documentation concepts are missing and causing a lower level of specificity.

Tip #4: Track coding and billing efficiency trends.

CMS predicts that your accounts receivables will rise. Let your data identify where any bottlenecks may exist in coding and billing. Discover and resolve these bottlenecks to reduce their impact on your revenue.

Tip #5: Mitigate compliance risk related to ICD-10.

Your compliance department must remain diligent after ICD-10 takes effect. ICD-10 will magnify the potential for documentation and coding compliance issues. Let our compliance risk rules engine scan your claims on a daily basis so you can identify potential ICD-10 audit targets and areas of risk.

For more information about how MedeAnalytics can help you measure, monitor, and benchmark the impact of ICD-10 on your revenue, visit www.medeanalytics.com/revenue-integrity or contact us at info@medeanalytics.com.

Be sure to visit us at AHIMA, booth #1443, September 26-30. To schedule a private demonstration, email Katie.Broussard@medeanalytics.com.

Posted in

MedeAnalytics

MedeAnalytics is a leader in healthcare analytics, providing innovative solutions that enable measurable impact for healthcare payers and providers. With the most advanced data orchestration in healthcare, payers and providers count on us to deliver actionable insights that improve financial, operational, and clinical outcomes. To date, we’ve helped uncover millions of dollars in savings annually.

Leave a Comment





Get our take on industry trends

risk-based-approach-featured

Will adopting a risk-based approach with augmented analytics support care gap closure?

February 24, 2023

A common challenge for healthcare systems is how to properly segment its patient populations based on risk profiles and co-morbidities. Doing this well ensures a high quality of care delivery and superior patient outcomes.

Read on...

4 questions healthcare executives are asking about augmented analytics

November 29, 2022

At our annual Impact Summit, I had the privilege to talk about augmented analytics and address questions from healthcare executives—many…

Read on...

Using data analytics to combat the maternal health crisis

November 18, 2022

With most pregnancy-related deaths being considered preventable, why is the United States facing a maternal health crisis? The country’s maternal mortality rate is the highest of any developed nation in the world and more than double the rate of peer countries.

Read on...
Dr. Lyle Berkowitz

Q&A with Dr. Lyle Berkowitz: Diving into the future of AI, analytics and precision medicine

October 21, 2022

Estimated reading time: 4 minutes After an excellent keynote session led by Dr. Lyle Berkowitz at our 2022 Impact Summit…

Read on...