Do Not Expect Further ICD-10 Delays
Editor’s Note: This article was written prior to the deadline. Currently, ICD-10 is the only standard for submitting diagnosis codes on claim forms.
It was this time last year that we announced yet another delay in the ICD-10 implementation. In fact, only two weeks prior to last year’s delay, the Administrator of the Centers for Medicare and Medicaid Services, while addressing a health care association, said, “There are no more delays and the system will go live on Oct. 1. Let’s face it guys, we’ve delayed this several times and it’s time to move on.” Promises, promises.
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However, due to the sheer enormity of the change, providers simply cannot wait to see if there is going to be another delay in 2015. First, we have no reason to believe that there will be further delays. As a result, your office must be ready for ICD-10 beginning October 1, 2015… less than 6 months from the time you will read this article. It is critical to remember that ICD-10-CM implementation is not optional. All providers will be required to comply.
We still get questions at the ICS office about the necessity of ICD-10. In short, there is not enough specificity within ICD-9 for our current modern day world. ICD-9 was first released in 1975 and was the first classification system that was not for mortality only. It was designed to only account for a certain level of precise diagnosis and can only account for about 17,000 codes. 40 years later, we live in a world that requires more from everyone, including the provider, in order to present better data globally. Although ICD-10 was introduced in the early 1990s and many other countries have adopted it, the United States is only now moving to ICD-10-CM (Clinical Modifications).
We have provided a number of articles that have given our members a breakdown of the ICD-10-CM structure and usage. However, in this article, I am focusing on the importance of moving implementation forward in your office. Here are a few critical elements you should make certain are in place within your practice:
Documentation (Start Today)
Chiropractic physicians, along with all other health care professionals, are going to have to increase both the accuracy and specificity within the documentation. This is not a revelation, nor should it be any surprise to our readership. The ICS has been imploring our doctors to improve documentation for years. Because the documentation must always support the diagnosis and service codes, and because ICD-10 is more specific, then the documentation must also become more specific. If you would like additional assistance, you may use the American Academy of Professional Coders’ clinical documentation assessment program, or you may contact a medical compliance consultant.
Billing and EDI (Check Today)
The billing software and/or billing companies that you utilize in your office must be able to handle ICD-10-CM. Additionally, your Electronic Data Interchange provider must be able to account for ICD-10-CM no later than October 1, 2015. Start today by confirming, in writing, ICD-10-CM readiness with all of your billing entities. If they are not ready today, providers should follow up every two weeks until your billing entities are ready.
Training (Today forward)
Have BOTH you and your staff started the training process for ICD-10-CM? It is critical for both the provider and any staff who will be part of the documentation process (i.e. transcriptionist), billing, or any other facet of diagnosis, to be fully trained. This will not be a short and easy process. The ICS has held a number of live training seminars for ICD-10-CM and will continue to offer training. Please visit www.illinoiscme.com for more information about upcoming live regional seminars. In fact, ICS members have access to our online education and upcoming webinars specifically for ICD-10-CM training at no additional cost. We have a 10-part ICD-10-CM distance learning course (portions online and portions webinar) available for all of our members. See the listing of distance learning courses at the end of this article.
Medicare Diagnosis Codes (September 2015)
At the time of this writing, National Government Services (NGS) has not released the acceptable diagnosis codes for Medicare billings. We anticipate that release to come sometime in September 2015. Please watch NGS and ICS releases for these acceptable codes.
Testing (Not later than August 2015)
You should be able to test your billing and clearinghouse systems using ICD-10-CM by August 2015. Work closely with these entities to ensure the coding is transmitting appropriately.
Regardless of the number of delays, the implementation of ICD-10-CM is inevitable. The steps you take today can help mitigate any problems after the deadline, create a smoother transition, and bring peace of mind to you and your staff.
Available Online Now (online education)
- Basics – “Who Thinks ICD-10 is a Good Idea Anyways…”
- Next Step – “Coding Hierarchy and Coding Rules”
- Risk Assessment with ICD-10
- Is Your CPT® Coding Correct
- Medicare and ICD-10
There are many other courses available in our on-demand library related to ICD-10. Please visit www.illinoiscme.com to view these courses.
