On October 1, the tenth edition of the International Classification of Diseases—commonly known as ICD-10—goes into effect at hospitals, clinics, nursing homes, and practices throughout the United States. The updated coding system will require physicians and facilities to report substantially more information to government programs and private insurers about the care they deliver.
To help locum tenens providers, permanent staff, and facility and practice representatives in the transition to ICD-10 coding, we curated a collection of timely tips and insights from healthcare industry experts and other trusted sources.
- If care started before October 1, use ICD-9. As PT in Motion News reports, a new referral or plan of care will not be required if an episode of care commences before the ICD-10 compliance deadline and continues after October 1.
- It is essential to determine actions that will adversely affect the revenue cycle.“Everyone is expecting some lost productivity among all players of the healthcare industry,” states Karen England, MBA, CPC, revenue cycle consultant at Ingenious Med, in an article published by RevCycleIntelligence.com. “However, the ability to identify activity which negatively impacts the revenue cycle is critical, considering no one is quite sure what that lost productivity will actually look like.”
- Providers may find “crib notes” advantageous. For common diagnoses, Jim Daley, director, IT WEDI past-chair and WEDI ICD-10 workgroup co-chair of BlueCross BlueShield of South Carolina, tells RevCycleIntelligence.com it may be beneficial for providers to keep notes on hand as a work aid.“Some of the doctors have cheat sheets,” he says. “Those might be a good thing to address because it probably doesn’t take that much time anyway. But you don’t necessarily need your cheat sheets to be updated to get paid. Those are for internal usage. It may make it easier for you to do your operations, but they’re indirectly involved in the revenue cycle.”
- The process for looking up codes will be familiar. According to the Centers for Medicare and Medicaid Services (CMS), while there are more diagnosis codes—68,000 available for ICD-10 as opposed to 13,000 for ICD-9—an alphabetic index and electronic tools are offered to assist users with code selection.
- Adding a seventh character when not required can result in claim denials. Conversely, if a provider does not use the seventh character where necessary, a claim will be rejected—even within the CMS’s yearlong grace period. (For more information, see CureMD’s post titled, “The Elusive 7th Character in ICD-10.”)
- CMS offers other options if ICD-10 claims cannot be submitted electronically. Providers experiencing problems with their systems may download free billing software for their Medicare Administrative Contractor (MAC). Roughly 50 percent of MAC jurisdictions have an online portal for Part B claims submissions as well, relates HealthITAnalytics.com. What’s more, if they meet provisions outlined in the Administrative Simplification Compliance Act waiver, organizations unable to use these tools may also submit paper forms.
To stay informed of the latest ICD-10 news and resources, visit the CMS ICD-10 website.