tci Medicare Compliance & Reimbursement - 2014 Issue 7
ICD-10 Transition: Ensure You're on the Same Page as Workers' Comp Insurers with ICD-10 Issues
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Article Overview
This article reviews practical ICD-10 transition concerns for providers and billing teams. It focuses on coordination with non-covered entities, readiness checks for vendors and third-party billing services, handling ICD-9 backlogs, and preparing for CMS testing and claims workflow changes. The piece is relevant to healthcare providers, coders, billers, and revenue cycle staff who need a broader transition checklist.
Why This Topic Matters
ICD-10 readiness affects not only internal coding teams but also payers, billing vendors, and downstream services that rely on diagnosis coding. The article helps readers understand the operational issues that can disrupt claims processing and testing during the transition period.
Article Sections
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Keep An Eye on ‘Non-Covered’ Entities
This section discusses payer categories that are not subject to the same transition requirements as covered entities and explains why communication with them matters during ICD-10 adoption.
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Don’t Be Daunted by Size of Code set
This section addresses the scale of the ICD-10 code set, staff education concerns, and responsibility for vendor readiness and claim submission support.
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Tackle Backlogs
This section covers the operational importance of clearing older claims work and preparing for the broader workflow impact of diagnosis coding during the transition.
What You Will Learn
- Why ICD-10 transition planning must include outside payers and billing partners
- What types of organizations may not be required to transition at the same time
- Why backlog cleanup is considered part of a smooth transition strategy
- How CMS testing fits into ICD-10 readiness planning
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Healthcare providers
- Practice administrators
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