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Referrers Are Your ICD-10 Partner
By Jim Knaub

If your imaging facility has difficulty matching documentation now, expect it to be worse when ICD-10 implemenation kicks in on October 1, 2014. That’s what experts are saying—OK, it’s one thing they’re saying—about the oft-delayed transition.

Radiologists and referring physicians, as a result of the implementation, will need to provide each other with more information for accurate billing and coding. It’s both a challenge and an opportunity for imaging facilities. On the radiology side, reports need to include all information that supports the diagnosis codes in a given patient encounter.

Attending physicians will rely on information that radiologists provide to meet ICD-10 documentation requirements for diagnoses, says Cortnie R. Simmons, MHA, RHIA, CCS, CDIP, director of ICD-10 services for Kforce Healthcare Solutions.

Given the greater specificity required by ICD-10, imaging organizations must understand what their referrers need in those reports and make sure radiologists are trained to provide that information. While the information burden is a challenge, getting it right and reducing the number of extra calls needed to support coding offers a real opportunitity for facilities to satisfy their referrers.

At the same time, Simmons notes referrers will need much more detailed information about the reasons for their patients’ visits and exams. Breakdown in workflow and documentation will increase denials and interrupt reimbursement while issues are resolved concerning appropriate code assignment in the ICD-10 system.

Both imaging facilities and referrers will benefit from communicating about what each side needs from the other to code, bill, and receive proper reimbursement with minimal (eventually) back-and-forth communication to create clean claims.

Few expect ICD-10 to be delayed again, and October 1, 2014, is less than 18 months away. While your organization’s in-house plans may be progressing, don’t overlook imaging’s important stake: including referrers in your ICD-10 planning.

— Jim Knaub is editor of Radiology Today.