ICD-10 implementation clock ticking

With the deadline for implementation of ICD-10 just five months away, a lot is being written about whether medical practices are prepared. As late as April 30, Rep. Ted Poe of Texas introduced a bill that would prohibit the Secretary of Health and Human Services from replacing ICD-9 with ICD-10 in implementing the HIPAA code set standards.

Two other lawmakers, Rep. Andy Harris of Maryland and Sen. Bill Cassidy of Louisiana, also favor delays. Harris has proposed adding a “hardship exemption” to an appropriations bill to let unprepared providers temporarily skip ICD-10, while Cassidy recently told a Senate committee “the reasonable thing would be to delay the penalty phase for two years as people transition.”

While these latest developments could result in another delay, it is not recommended that healthcare providers bank on it.

As of today, all covered entities as defined by HIPAA, must adopt the codes, effective Oct. 1. Despite the many delays and warnings, just a little more than 50 percent of practices have even started to move in the direction, according to the latest surveys.

That said, what are some things you can be doing now?

First, it’s important to understand that while there are 13,000 diagnosis codes under ICD-9 and will be 68,000 codes under ICD-10, there’s a good chance your practice will use a small number of them.

If you didn’t participate in acknowledgement testing in March you will have another chance. The Centers for Medicare and Medicaid Services announced that it will run ICD-10 acknowledgement testing again from June 1 through June 5. This will give healthcare provides a chance to test out their coding procedures ahead of the Oct. 1 switch to the new coding vocabulary. To learn more click here.

If you haven’t done so, now would be a good time to check with your billing service, clearinghouse, or practice management software vendor about their plans for ICD-10 compliance. Providers that handle their own billing and software development should plan for medical records/coding, clinical, IT, and finance staff to coordinate efforts on ICD-10 transition.

Other things to take into consideration include:

  • How prepared are your coders? Have they been dual coding so that they know ahead of time how the different code sets are related and how they are different?
  • Do your coders understand what additional documentation is needed from providers to correctly code each case?
  • Have you tested your system to see how it works with your Medicare administrative contractors as well as private vendors? Don’t wait until the last minute to find out if your payers are ready to convert to ICD-10.
  • Are you prepared for glitches? What will you do if payers are not able to process claims for some time? Do you have enough money in your reserves until the problems are resolved?

Still have questions? The Health Law Offices of Anthony C. Vitale can assist

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The Health Law Offices of Anthony C. Vitale