Overcoming Issues Relative to Medicare Reimbursement & ICD-10

medicare-reimbursementIf you aren’t prepared for the ICD-10 deadline that is coming on October 1, 2015, chances are you are going to need some help. One of the best ways to get your otolaryngology management billing and coding under control so you won’t miss out on getting that Medicare reimbursement is to concentrate your focus on what is most important. ENT practices have a very focused spectrum of healthcare codes that they will use for a majority of the time. Unlike busy emergency rooms, hospitals and urgent care clinics, which will likely use a wide range of the new codes, you have the ability to take some time to learn all of the codes that are applicable to your practice, without being bogged down by the rest of the 150,000 or more codes that you won’t use.

One way to accomplish this is to hire a healthcare consulting firm, such as MD Pro Solutions, which specializes in serving clients in the otolaryngology field. They can help you put the focus where it really belongs and prevent you from being distracted by all of the other issues that don’t really effect your practice. Otolaryngology management billing and coding under the new ICD-10 deadline doesn’t have to be that complex. All you have to do is take the time to sit down with an experienced professional and find out what you need to learn and what upgrades to your system have to be done.

The Sky Is Not Falling
Regardless of what you might read on industry message boards or see in well-meaning medical publications, it really isn’t all that drastic. While there are some concerns about getting it all under control to prevent the rejection of claims under Medicare reimbursement, there are services that can help you sort it out. You don’t have to go it alone. Many practices are choosing to outsource billing and coding services for at least the first year to ensure that they have all the “bugs” out of the system and to prevent office employees from being overwhelmed by all the changes at once.

While there are many things that are changing, there are also many things that are staying the same, so it’s not like you have to learn a completely brand new system for Medicare reimbursement and otolaryngology management billing and coding. According to reports from folks in the know, the MS-DRG payment calculation that will be used after the ICD-10 deadline will be a replica of the current system. While there will be some payment redistribution based upon the inherent differences between ICD-9 and ICD-10, experts are saying that it won’t be as drastic as many have feared.

A report published by the Centers for Medicare & Medicaid Services (CMS) revealed that 99 percent of the cases that were studied in a recent review showed no change in the Diagnosis Related Groups (DRG) when the ICD-9 and ICD-10 Medicare Severity Diagnosis Related Groups (MS-DRGs) were compared. So if the major Medicare reimbursement for your clinic or hospital is based upon the DRG, it will be possible to determine the obvious differences after the ICD-10 deadline. However, this will not affect most otolaryngology management billing and coding, so it is important to just focus on the codes that you will be using the most.

Should You Anticipate a Financial Impact?
The answer to this question is, quite frankly, it depends. This might sound evasive, but the truth is that any impact felt within the ENT practice with regard to Medicare reimbursement for otolaryngology management billing and coding will depend on how prepared you are for the ICD-10 deadline. The amounts of the reimbursement shifts will vary based upon the unique DRGs that are being used. Some practices will see a slight increase in Medicare reimbursement, while others might experience a slight decrease.

One way to ensure that you do not experience any impact due to human error or failing to comply with the changes coming with the ICD-10 deadline is to hire a professional healthcare consulting firm to go over all of the changes with you and your office billing staff. They can assess your current progress, help you with training and even suggest to you software upgrades and other tips that will help make the transition even easier.

MD Pro Solutions specializes in otolaryngology management billing and coding. Our team can help you meet the demands of the upcoming ICD-10 deadline to ensure you don’t see any significant financial impact from Medicare reimbursement. Call today at 508-946-1665 to get a FREE evaluation from our knowledgeable and experienced staff.