While the rest of us celebrate the incoming New Year, many Physical Therapy professionals will admittedly be viewing the calendar change with some trepidation. The reason for the unease are the new ICD-10 codes and guidelines that take effect on January 1, 2017. Most providers have been fully immersed in coding over the previous 12 months as the grace period for ICD-10 flexibility ended on October 1st.
Why are the new changes being implemented? The main goal with the new codes is to drive greater specificity in evaluations and reevaluations. The codes for PT evaluations now reflect three levels for patient presentation, to include low-, moderate-, and high-complexity. CMS is hopeful that the implementation of a complexity-based system for evaluations will result in more useful historical data to define the treatments that patients are receiving.
How Should Providers Prepare for ICD-10 Changes? With the changes to ICD-10 codes days away, hopefully, providers have done their homework and made themselves aware of the new codes. Because the period of coding flexibility has expired, it is critical that providers gain the necessary knowledge to ensure they are ready to go on January 1, 2017.
What Learning Resources are Available to Providers? Fortunately for PT providers, there is an abundance of material available to help everyone get up to speed with the new ICD-10 codes. For a bare bones guide to the new evaluation codes, the American Physical Therapy Association (APTA) has published reference material found here. APTA also has a self-paced online course available. If providers want to dig a little deeper, a recording of an Evaluation Code webinar can be found here. The recording is just under an hour long and features questions and answers that were asked during the original presentation. Providers can also find information on all of the ICD-10 updates at CMS.gov with downloadable guides found here.
What are the Next Steps for Providers? Ideally, providers will want to analyze the impact the new ICD-10 system is having on their practice. Performing assessments do not have to be a lengthy and cumbersome process, but is an important step to identify issues with productivity, reimbursements, and the claims process. Being proactive about your systems can identify cash flow bottlenecks, staff training opportunities, and other factors that impact productivity. CMS has designed an assessment toolkit that outlines several key ways that ICD-10 data can be used.
As 2016 draws to a close, we can reflect on all of the progress that was made throughout the past year of ICD-10 implementation. And now, as we like to say at this time of the year, “Out with the old and in with the new!” Here is wishing you and yours a Happy, Healthy, and Successful New Year! Now that we've reviewed everything there is no need to stress about the end of the grace period, or the new codes, celebrate what you have accomplished and toast to what lies ahead. After all, by 2022 we will be talking about ICD-11 implementations!