Electronic Health Records

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ICD-10 Coding Concerns Dispelled with 5 CMS Facts

By Vera Gruessner

There have been a variety of ICD-10 coding concerns popping up across the healthcare sector, from physicians, nurses, billers, health IT specialists, and many more professionals. The Centers for Medicare & Medicaid Services (CMS) spoke with providers throughout the country and identified certain myths about the ICD-10 transition that many are worried about. Below are five facts that should dispel these myths and allay ICD-10 coding concerns.

  1. The ICD-10 Transition Deadline is Set

CMS encourages providers and payers to be prepared by October 1 for the ICD-10 transition because additional delays will not be occurring. Even though there were two delays beforehand in the past few years, ICD-10 coding concerns about another postponement are not valid, CMS explains. The deadline is set for October 1 and providers need to be ready.

The majority of healthcare providers, payers, and federal agencies have invested large funds in transitioning to ICD-10 coding. Any further delays will only lead to a rise in healthcare costs.

  1. Physicians and Healthcare Professionals Don’t Need to Use 68,000 Codes

Since physician practices do not currently use all 13,000 diagnosis codes applicable in the ICD-9 coding set, there will be no need to utilize every one of the 68,000 codes in ICD-10. These ICD-10 coding concerns are also based on a myth. Only a small subset of the total amount will be used.

  1. ICD-10 Codes Will Be Viewed in a Similar Fashion to ICD-9

Even though the ICD-10 coding set has more diagnosis codes, this does not make it harder to utilize. There is still an alphabetic index and digital tools that doctors and nurses can use to help select the right codes when treating patients.

  1. Codes Related to Outpatient and Office Processes are Staying the Same

Some ICD-10 coding concerns also address potential changes to outpatient and office procedure codes but these processes are staying the same after the ICD-10 transition deadline.

The movement toward ICD-10 for diagnostics and inpatient procedure coding doesn’t impact using CPT for outpatient and office coding. Physician practices will continue utilizing CPT.

  1. Medicare Fee-for-Service Providers Are Given the Chance to Test with CMS Before the ICD-10 Implementation

A physician practice or clearinghouse has the opportunity to conduct acknowledgement testing throughout any point in time with their Medicare Administrative Contractor (MAC) until October 1.

Acknowledgement testing will help providers ensure they are capable of sending claims with ICD-10 codes to CMS and relevant entities. In June 2015, a specific week dedicated to acknowledgement testing will be conducted by CMS in which providers and payers will have access to customer service and help desk support. Those interested in the acknowledgement testing week are encouraged to contact their Medicare Administrative Contractor for more information and details about testing plans.

These five facts about the ICD-10 transition was put together by CMS to put providers’ minds at ease. Those with other ICD-10 coding concerns should work with CMS to address any issues.




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