https://www.cms.gov/ICD10/03_ICD-10andVersion5010ComplianceTimelines.asp

Another good link is a toolkit to help smaller physician offices prepare for all of the changes.

http://www.ama-assn.org/resources/doc/washington/5010-toolkit.pdf

The ACA is offering a variety of resourced to help with the transition.  Here is a PDF which gives answers to common questions about the transition to ICD-10 codes.

http://www.acatoday.org/pdf/ICD10FAQs.pdf

Remember that the transition period will be a bit challenging because ICD-10 codes are much more detailed than ICD-9.  However, in the long run I believe that practices will benefit from the more detailed codes and if chosen correctly, some of the denials that chiropractors routinely see because of the lack of documentation will be reduced.

For now, make sure your electronic billing gateway is compliant with 5010, and check out the links to help you prepare!  I recommend that each office appoint one staff member to learn about, train and oversee the implementation in your practice!  Remember, this will apply to all chiropractors!  Even small practices will need to be ready…as the ICD-9 codes will no longer be able to be used after Sept 30, 2013!

Stay tuned to this blog (you can subscribe to be properly notified of any new posts) and also on our Facebook page:  http://facebook.com/practicalca for updates and discussions!

Practically Yours!

the PracticalCA

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Practically Yours,

thePracticalCA

http://practicalca.wordpress.com/2008/06/19/the-role-of-the-chiropractic-assistant/

But if I could sum up in one sentence, the most important job responsibility a C.A. has, what do you think it would be?

First of all, I will share that I am surprised at how common it is for C.A.s (just like people in other jobs) to complain about some task that they are asked to do.  We can at times, fault the doctor or office manager who hired the person for not having a well defined job description for the new hire to agree to prior to being hired.  However, we all know that in a chiropractic practice, it is often difficult to list every possible task that the C.A. may need to perform.  So with that said, what is the most important thing?

Your job as a C.A., should be that you are to do what is necessary to ease the stress of the doctor.  When it comes to running a practice, seeing patients – being on their game as they are helping to heal people, doctors have so many stressors to deal with.  The last thing the doc needs is a C.A. who is not a team player!  Make sure that your doctor has defined the role he or she wants you to play in the practice.  And make sure that you have been properly trained to do that job, then go do it and do it well!  When a problem arises (which they will) then stop a moment and assess the issue.  What can you do to resolve the problem? What does the doc need to do?  Other employees involved?  Then their role needs to be considered as well.  The most important thing to do is to stop, breathe, assess and then go to your supervisor and without emotion, describe the problem, and then offer your solution to the problem!  Don’t just go complaining!  Also, understand that the decision to not use your solution may be their choice, so accept whatever solution is offered, and go to work!

I am surprised at how many employees will complain about being asked to do something outside of their immediate job description in a chiropractic practice.  Chiropractic office employees must be some of the most versatile employees of all professions!  The most important factor in being successful is the ability to accept the role of helping to make the office run as smoothly as possible, so that your patients have the best possible experience while in your office!

So in the coming week, make it a goal to do what you need to so that you can “ease the stress of the doctor” just a bit!

Practically Yours!

the PracticalCA

Here’s a link to the package that includes instructions as well as the form in both PDF and Word versions.  Not sure if you are already updated?  Make sure that your ABN has the 3/2011 date on the bottom of the form, NOT the old 2008 version by Nov. 1, 2011.  https://www.cms.gov/BNI/02_ABN.asp

Take a minute to review the forms with all of your staff, including the doctor.  An ABN form that is not delivered properly is void, so make sure that you know how and when to use the form!

***Updated, this has been changed to give practices until Jan 1. 2012 to implement the new form.****

Practically Yours,

the PracticalCA

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The following table provides a comparison of the features of the ICD-9 and ICD-10 diagnosis code sets.
Table 1 – Comparisons of the Diagnosis Code Sets
ICD-9                                                ICD-10
3-5 characters in length                        3-7 characters in length
Approximately 13,000 codes                      Approximately 68,000 available codes
                                                Digit 1 is alpha; digits 2 and 3 are numeric;
                                                digits 4-7 are alpha or numeric
First digit may be alpha (E or V) or numeric;
digits 2-5 are numeric
Limited space for adding new codes              Flexible for adding new codes
Lacks detail                                    Very specific
Lacks laterality                                Has laterality (i.e., codes identifying right vs.
                                                left)

Find out more, including the roll out dates in this PDF from the AMA:

http://www.ama-assn.org/ama1/pub/upload/mm/399/icd10-icd9-differences-fact-sheet.pdf

Practically Yours,

the PracticalCA

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Some of the sobering statistics which lead to the program, taken from the Partnership on the Healthcare.gov site:

• At any given time, about one in every 20 patients has an infection related to their hospital care.
• On average, one in seven Medicare beneficiaries is harmed in the course of their care, costing the government an estimated $4.4 billion every year.
• Nearly one in five Medicare patients discharged from the hospital is readmitted within 30 days – that’s approximately 2.6 million seniors at a cost of over $26 billion every year.

If you or your patients believe that you have been affected by their practices, check the link at the bottom of page:http://tinyurl.com/acauhc to file a complaint!

Stay tuned for further information on the lawsuit.

Practically Yours,

the PracticalCA

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Seriously!  The ADA and its associated dentists have spent millions educating the public to “every 6 months” dental exams.  Are you expecting this minimum from your chiropractic patients?  We know the importance of a healthy smile! But what about the importance of a healthy spine?  Doc, if you feel that this is a proper recommendation for your patients, what a better way to remind them that it’s time to come in, than to send out a simple notecard reminding them that  it’s time to have their 6 month spinal exam!  Make sure that you are HIPAA compliant and DO NOT send a postcard to any patient unless you have a proper release signed.  (Postcards are fine for promos to non-patients.) Get some small personal note sized cards, and print a nice and simple message.  Simple:  ”It’s time for your 6 month exam.  Please call our office at 555-1234 and schedule TODAY!”

The education that the ADA and their dentists have spent millions on, will make the inactive patient understand that 6 months is the max they need to go without getting a checkup!

Practically Yours,

the PracticalCA

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*The counsel for the American Dental Association contacted me and asked that I let you know that they no longer “allude” to every 6 month dental checkups, that some people need to see a dentist more frequently etc.  They do have specific guidelines now that they recommend for good oral health.  Upon googling “the American Dental Association recommends a checkup every 6 months.” I returned 266,000 pages (mainly of private dentists) who use that statement (including using the American Dental Association’s name) on their sites as recommendations for their patients.  The American Academy of Pediatric Dentistry was also mentioned as having that recommendation- via dentist’s web pages.

True!  Many people can rise to the occasion and handle the “big” things that must be handled at that moment while everything else just grinds to a stop.  But true success comes not so much from being able to rise to handle the big things, but rather taking care of the little things on a day to day basis.  If you take care of the little things, you are much less likely to have to deal with the “big” things.

Look around your clinic and make a list of the “little” things that may need some care.  Are you following up on missed appointments?  Are you getting out records requests in a timely manner?  Are you making appointment reminders, doing birthday cards, filing and shredding or other similar task on a regular basis?  Make a plan to implement systems which will get these things in order and before long, your office will be running smoother, and you will have more time to focus on the things that really matter: your patients.

Practically Yours,

the PracticalCA

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If your doc is a great organizer, but maybe lacking in follow through, it serve the clinic best if you can help to organize tasks and assist in following up on his or her progress in finishing.

If your doc is a great doctor, but maybe lacking in that outgoing personality, make sure you do your part to engage the patient and give them a little extra attention when possible.

Make sure that you are not overstepping the boundaries that were set, as far as setting up new systems and procedures in the office.  If you are unsure of exactly how much you should do on your own, then ask.  Talk about responsibilities at your clinic meeting.  Then talk again after each new program is implemented to make sure that everyone is on board.

Reassess as often as needed to figure out what works for your clinic/doc and then stick to it! Urge your doc to stay on board as well, but you will need to figure out the balance of taking charge and being too pushy.

Remember the ultimate role of the C.A. is to ease the stress of the doctor.  Keeping an organized office is a great start in easing stress levels in the clinic.

Here is a blog post on organizational skills, which can be adapted to a chiropractic clinic:

http://www.onlineorganizing.com/NewslettersArticle.asp?newsletter=ol&article=472

Practically Yours,

the PracticalCA

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