George Breen, Bethany Hills, Jackie Selby Featured in “How Providers Should Address Post-Implementation ICD-10 Challenges”The Daily Briefing November 6, 2015
George B. Breen, Bethany J. Hills, and Jackie Selby, Members of the Firm in the Health Care and Life Sciences practice, were featured in the Advisory Board Company’s The Daily Briefing, in the Q&A, “How Providers Should Address Post-Implementation ICD-10 Challenges.”
Following is an excerpt:
DB: How will the transition to ICD-10 affect compliance departments?
A: Providers need to recognize that the transition to ICD-10 impacts more than just revenue stream or billing and coding. This transition plainly impacts compliance departments. Consistent with an ever increasing focus on payment for quality and medical necessity, health care providers must ensure that the medical record contains enough specificity for the selection of the ICD-10 code that best reflects that condition.
If a clinical record does not contain enough information to support the selection of a specific code, the compliance department must understand the impact of this inconsistency on the claim and be able to determine whether there is a reimbursement impact. Indeed, billing, compliance and professional staff should have comparable training and apply consistent standards in creating and evaluating the medical record and identifying the appropriate ICD-10 code.