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Maybe ICD-10 Will Just Go Away...

Published:  June 14th, 2013

Maybe ICD-10 will just go away...

Or maybe not. In case you have not heard, the ICD-9 codes that you have been using on claim forms since the late 1970s will cease to exist as of October 1st, 2014. You may have also heard that the entire country was supposed to switch to the tenth revision of the diagnosis codes, known affectionately as ICD-10, sooner, but the date has been moved. Some coders and health care providers hope that the next date will be postponed as well. In fact, there are many optimistic procrastinators. Six months ago the American Medical Association (AMA) petitioned the Centers for Medicare & Medicaid Services to postpone or even skip ICD-10 implementation (and go straight to ICD-11). The coding world got nervous until Marilyn Tavenner, the Acting Administrator for the Centers for Medicare & Medicaid Services (CMS), spoke up and reaffirmed that the conversion will not be postponed.  
 
On February 6, 2013, she wrote, "Halting this progress midstream would be costly, burdensome, and would eliminate the impending benefits of these investments. Many private and public sector health plans, hospitals and hospital systems, and large physician practices are far along in their ICD-10 implementation and have devoted significant funds, resources and staff to the effort." She further stated, "We believe the one-year extension to September 30, 2014, offers physicians adequate time to train their coders, complete system changeovers, and conduct testing. Staying the course with ICD-9 is not sustainable in an electronic health environment."

Claims for healthcare services provided on or after October 1, 2014, must contain ICD-10 codes. There will be a lot to do before then to get ready, but don't worry, ChiroCode has everything you need, from books to webinars, to training for your state associations  (Call us to find out more).  

Here are a few frequently asked questions about the October 1st, 2014 deadline  (you can find more at https://questions.cms.gov/faq.php):

How do I report ICD-10 codes on claims when the dates of service span from prior to10/1/2014 to on or after 10/1/2014?

-Many payers  are requiring claims with dates of service that span the October 1, 2014implementation date to be split so that the services prior to 10/1/2014 are billed separately and utilize ICD-9 codes;  services on and after 10/1/2014 are billed separately and utilize ICD-10 codes.  Check specific payer guidelines for processing claims for services that span the 10/1/2014transition date.

If I submit or process a transaction with an ICD-9 code for a date of service after October 1, 2014, am I HIPAA compliant?

-The date of service determines the compliant code format to be used in a claim regardless of the date the claim is filed or submitted.  Providers will submit claims after October 1, 2014 with ICD-9 codes when the services were performed prior to October 1, 2014.  Payers will process claims if received after October 1, 2014 with ICD-9 codes when the services were performed prior toOctober 1, 2014.  This situation is HIPAA compliant.  

How long after the October 1, 2014 ICD-10 compliance date must I continue to report and/or process ICD-9 codes?

-Each payer determines their late filing requirements for standard transactions and ICD-10 does not require a change to these requirements.  These deadline requirements vary among plans.  Contact your payer for the current information regarding late filing for claims.

 

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