Understanding How Current and Projected Patient Volumes Can Ease ICD-10 Coding Inaccuracies

By Infinx
January 15, 2020

Whether you are in a large, hospital-based practice or a smaller independent office, you have probably encountered an influx in patient flow that taxes the system and feels overwhelming to your providers and staff.  Maybe it’s flu season, or maybe it’s near the end of the year, and you anticipate people taking advantage of annual deductible limits and co-insurance maximums.

Whatever the reason, some of these surges in patient visits can be anticipated and will bring with them increased workloads throughout the entire patient encounter and subsequent healthcare payment lifecycle.  This is powerful information to have in advance and can preemptively create opportunities to plan for proactively managing everyone’s expectations.

Increased Visits and ICD-10 Coding Inaccuracies

One of the most significant areas impacted by the increase in patient visits is revenue cycle management (RCM) and, specifically, ICD-10 coding.  Each step of the process can suffer from the increased number of claims and the pressure to quickly complete each task along the way.

With this knowledge in hand, you can be proactive and meet the predictable head-on.  Let’s look at how each step of the visit and coding process can be addressed in a way that positively impacts the whole.

  • Pre-Surge Preparation – Now is the time to call together your entire team and review each position’s responsibilities, the coding function, and any new updates or changes that should be anticipated.  Being prepared goes a long way in reducing errors when things heat-up
  • Patient Visit – During the visit, all procedures performed, tests ordered, and billable supplies used need to be recorded accurately and double-checked to ensure nothing is missed
  • Provider Coding Guidelines – Having adequate time pre-scheduled between patients so that the physician or Advanced Practice Provider (APP) can ensure they have met coding criteria and all forms are filled out appropriately
  • Medical Chart Completion – Institute an end-of-day goal for all providers to have their superbill completed, the medical charting done, and the documentation ready for the billing office
  • Coding – With the influx of patients comes increased workflow that moves through the coding and RCM process as well.  It is worth a little extra time spent on the coding and review process now if it might alleviate a backlog of denials and rejections down the road
  • Follow-Up by Optimizing Account Receivables – Against all best efforts, there may be an upsurge in denials and follow up work.  If the documentation and coding were done well initially, this process could be much smoother and more efficient, and reimbursement can be captured quickly

Patient flow has been an area that has focused on the mechanics of how a practice or clinic operates, i.e., where are the bottlenecks, minimizing unneeded crossing of paths, etc.  Think of the RCM process, and more specifically, ICD-10 coding inaccuracies from that same perspective, and to impact reimbursement during times of increased business positively.

Contact us today to schedule a demo that will increase AR optimization through improved coding and billing.

About the Author

Infinx

Infinx

Infinx provides innovative and scalable payment lifecycle solutions for healthcare practices. Combining an intelligent, cloud-based platform driven by AI with our trained and certified coding and billing specialists, we help clients realize revenue, enabling them to shift focus from administrative details to billable patient care.

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