Exactly how the switch to ICD-10 will affect revenue and productivity is still unclear, but this much is certain: Patient access managers will be fielding a steady stream of questions from employees for some time to come.
Anticipating some inevitable confusion, Mansi Patel, MPH, manager of patient access quality assurance and training at Children’s Healthcare of Atlanta, created an electronic form that can be used just for this purpose.
“Schedulers and registrars can submit questions and get timely responses from a subject matter expert,” explains Patel.
Here are some actual questions submitted by patient access employees and the responses they received:
Question: Patient access services (PAS) staff enter specific complaints during arrival of patient, but clinical staff is coming behind them and changing the complaint once the patient is triaged. Often, the specific complaint is being changed by clinical to a very general complaint. If clinical staff is going to come behind PAS staff during triage and change the information PAS staff enters, is it necessary for PAS staff to take the time to ask follow-up questions, while ensuring that the complaint is as specific as possible?
Answer: Yes. PAS staff should continue to use ICD-10 documentation best practices, since they are documenters in the medical records. The clinical staff needs to be made aware of this, so they can adopt the same best practices.
Question: If a patient originally was scheduled and approved for a visit in September with ICD-9 codes but was rescheduled to visit after 10/01, is the authorization OK with the old codes? Or would we need to resubmit with new codes?
Answer: You would need to resubmit with new ICD-10 codes for dates of service after 10/1.
Question: Some payers are not set up to receive ICD-10 codes when submitting authorization for patients that are scheduled after 10/1/15. Should we wait until 10/1/15 to submit for those?
Answer: United Healthcare and Kaiser will accept ICD-9 codes for authorizations obtained prior to 10/1. Please let me know if you have a specific payer you had a question about, and I can provide you with next steps.
