Urgent Care After ICD-10CM/PCS

There will be many changes with everyone after Implementation begins. Urgent Care will see huge demands on the accuracy of information needed from the patient with the requirements for external causes.

The first encounter will need the specificity as well as accuracy that we hear so much about when it pertains to ICD-10CM/PCS.

The When?

The How?

The Where?

The What?

These will be key questions when a patient comes in and says they had a FALL!

When did the Fall happen?

How did you Fall?

Where were you when you fell (work)?

What were you doing to cause the Fall?

This information is going to drastically change the productivity of the coding staff.  If these points are not addressed in the beginning with the first encounter there may be a snowball effect of issues. This will impact not only coder productivity but reimbursement as well.

Payers will be looking out for these codes, already knowing these codes need triggers to indicate everything needed in order to pay the claims.

Urgent Care sees many sprains and falls. Can you imagine the impact of low reimbursement if these questions are not covered?

TIPS:

Query your payers and ask them questions such as

Can you tell me which codes will see the most changes?

What requirements do you expect for these changes?

Remember it's up to you to connect with the payer, it is not the payer's responsibility to connect with you!!