Dual coding may be required for ICD-10

Providers who are are working toward achieving meaningful use incentives in 2014 know that this electronic health records program is not the only thing they have to worry about this year. They also have to prepare for the transition to the ICD-10 coding system, which could be a complicated process if providers are not prepared. While some professionals may have been testing and preparing for this for some time now, research continues to show that many other have not.

Recently, Government Health IT published an article by Carl Natale, an editor at ICD-10 Watch, who explained that most providers will likely find themselves having to do dual coding in order to have a successful transition. Natale said that this means that they will assign both ICD-10 and ICD-9 codes to medical records, and it may actually be beneficial to providers, though it will be time-consuming

Dual coding comes with upsides
According to Natale, dual coding has a number of benefits for doctors, especially those who are concerned about their billing processes getting stalled during their transition. For example, using both ICD-9 and ICD-10 will help providers recognize where their clinical documentation workflows could be improved, and where doctors may be in need of additional billing training. Furthermore, it will allow providers to compare data and note any potential changes in reimbursements that may come when ICD-10 is officially implemented in Oct. 1, 2014. 

However, while these benefits are clear, that does not mean that dual coding will be simple and inexpensive. Providers will need EHR systems that are capable of this type of coding, and even if their systems are ready, that does not mean that medical staff should not expect some stalls in productivity. 

"It's very likely that you will need to assign extra coding resources. For example, let's guess that dual coding will mean a 50 percent drop in productivity. If your medical coders process four medical claims, then they will only be able to process two under dual coding. To keep the number of claims consistent (and preserve cash flow), staff needs to be scheduled to process those two lost claims. Extra medical coders can be hired to cover the dual coders. Healthcare providers need to do a cost-benefit analysis to determine if it's better to hire personnel or accept longer reimbursement cycles," Natale wrote for Government Health IT.

He added that it is important to note that spending extra time on coding now could pay off for practices on Oct. 1. 

Providers prepare for dual coding 
Fierce Health IT spoke to Stephen Stewart, chief information officer at Henry County Health Center in Iowa, who explained that his hospital is planning on continuing with dual coding through the 2014 calendar year. However, the news source also spoke to Colleen Deghian, the senior program director for ICD-10 implementation at Cleveland Clinic, who said that once 2014 arrives, they have no intention of using ICD-9 codes along with ICD-10. 

"We will not be performing dual coding past the compliance date. We expect that if payers are not ready, they may map our claim back to ICD-9, but have no plans ourselves to perform dual coding after the compliance date," explained Deghian. 

That being said, she does expect ICD-10 to impact the productivity of the entire staff of the clinic. 

No matter what providers decide when it comes to dual coding, it is important that they plan accordingly and start acting now, if they have not done so already. October will come sooner than providers realize, and they do not want to get left behind.