Top 10 Insights Into ICD 10 Implementation

Posted by KUNAL JAIN on Aug 7 2015

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The clock is ticking and its less than 60 days left to meet the deadline for ICD 10 implementation. You are checking all the touch points, taking all the necessary steps, upgrading your systems to meet the deadline and breathe a sigh of relief! Add to that mix our Top 10 Insights  and  you will be on your way to flawless ICD 10 implementation.

Check these out before you call it a day.

TOP 10 INSIGHTS FOR FLAWLESS ICD 10 IMPLEMENTATION:

  1. MORE THAN 69000 CODES? NO PROBLEM.

ICD 9 system had approximately 14000 codes, while in ICD 10, the number has increased to more tahn 69,000 codes. Now, everyone seems to be concerned with the huge number of codes but tis concern should not be blown out of proportion. For example, if we look at all the ICD 10 CM codes, then around 50% of these codes are just for musculoskeletal system.

Thus the important thing to note here is that though the set of codes has increased dramatically, you will NOT use all the codes. In fact, each practice or, specialty will need to use only a small number of codes. So, it would be worthwhile to identify top 20 or so codes that your practice most often uses.

  1. BETTER PATIENT CARE.

The code set has been expanded from five positions (first one alphanumeric, others numeric) to seven positions. The codes use alphanumeric characters in all positions, not just the first position as in ICD-9. The new set of codes actually allows more information that can be conveyed through the code. And, that requires a significant increase in the specificity of the information that needs to be collected at doctor-patient interaction time.

This will hugely help when the patients come back for treatments –the physician will now have access to greater detail of previous diagnosis/treatments.

  1. ICD 9 & ICD 10 CM CODES HAVE SIMILARITIES.

Having similarities between the two systems makes it easier to learn and implement. Whether its ICD 9 CM or ICD 10 CM, Codes are looked up in the same way. In both these, a code will be invalid if it is missing a character.

  1. NEW ICD 10 CODES MADE AVAILABLE BY CMS

ICD 10 Code books are available in various formats- electronic, paper and mobile apps. To download a free pdf, click this link https://www.cms.gov/Medicare/Coding/ICD10/2015-ICD-10-CM-and-GEMs.html

  1. CONDUCT TESTING TO BE READY.

All providers can test their system with CMS before the deadline. In fact your practice can conduct acknowledgement testing with their Medical Administrative Contractor.

  1. CANNOT SUBMIT ELECTRONICALLY? YOU STILL HAVE A CHANCE.

If you are not ready as a practice to submit claims electronically by the deadline of October 1, 2015-don’t worry. (Though you will be in a better place to get your systems ready in time).  Here are the options if you find yourself in such a situation-

o   You can use a Free Billing Software to submit claims usindgICD10 codes. The billing software can be downloaded from any MAC.

o   You can use the Part B Claim submission portal that is available in about half of all MAC jurisdiction.

o   You can even submit paper claims as long as your practice meets the waiver provisions included in the law.

  1. CLAIMS WILL BE ACCEPTABLE ONLY WITH ICD 10 CODES.

Remember practices must prepare for ICD 10 codes because only those claims using proper ICD 10 codes will be accepted for services provided on or after the implementation deadline, October 1, 2015. It does not matter whether you use electronic submission or submit paper claims, your claims will NOT be accepted unless they are done with valid ICD10 codes( after October 1, 2015. )

  1. OUTPATIENT & OFFICE PROCEDURE CODES NOT CHANGING.

Outpatient and physician office procedures reimbursement will not be determined by ICD10. They will still utilize the CPT codes only, which are not changing.

  1. TRANSITION TO ICD10 A REALITY.
Transition to ICD 10 codes is a reality and its implementation deadline is October 1, 2015. A lot of information is being made available to reach the providers, to ensure that their systems are ready and ICD 10 compliant before the deadline. Non-readiness could prove to be costly severely impact your cash flow. Make sure you are ready and hopefully these insights will help you put things in perspective and prioritize.

  1. ICD 10 CONCESSIONS -LATEST.

Recently, CMS announced a concession in transition from ICD 9 to ICD 10 Codes. For one year past the Oct. 1, 2015 deadline, Medicare will not deny Part B claims from physicians or other practitioners considering only the specificity of the ICD-10 diagnosis code, as long as providers use valid codes “from the right family of codes.” This essentially means that you would still be reimbursed if wrong code is used in the claim as long as that erroneous code is in the same broad family as the right one.

WE CAN HELP TOO:

At Practice Forces, we are offering our clients seamless upgrade from ICD 9 to ICD 10. For physicians & practices that means, getting paid in time for their service with no worries of incorrect coding. And, at NO extra cost. Should your practice need any help in becoming ICD 10 compliant, we will gladly help you. Call us today for a FREE consultation, 866-634-6327 or email us at [email protected].

 

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Topics: Enrollment, Medicare, PECOS, Revalidation, NPI

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