Dual Coding: A burden or advantage for healthcare providers?

Carl Natale
by Carl Natale

The Medical Group Management Association (MGMA) still isn't over the final rule on the ICD-10 implementation deadline.

Robert Tennant, senior policy analyst at the MGMA, used a session at the group's annual conference in San Antonio, Texas, this week to complain about the ICD-10 code sets.

But he also stressed the need for early preparation. I guess that's some sign of acceptance And he had an interesting prediction:

“Most likely, many payers and clearinghouses won’t be ready. We will almost certainly have to have dual coding. That will create all kinds of issues for practices. We will see proprietary crosswalks across the industry.”

I'm not sure about that but my track record on predictions isn't so hot. It looks like most healthcare payers and clearinghouses are using the extra year to be ready by Oct. 1, 2014. Even if they aren't, medical claims will have to be submitted with ICD-10 codes. What's more likely to happen is an extended delay in reimbursements because unprepared healthcare payers will struggle processing medical claims. Which will be a lot worse than dual coding.

It looks like dual coding will be needed anyway. There will be non-covered entities - workers' compensation, auto insurance, disability insurance - that are not required to use ICD-10-CM/PCS and won't be ready Oct. 1, 2014.

[See also: Why non-covered entities will want to vigorously implement ICD-10 coding]

There is an opportunity to turn this into an advantage instead of a burden. There are healthcare organizations that plan to run dual coding systems before Oct. 1, 2014. This helps:

  • Test internal systems
  • Give medical coders practice with the ICD-10 codes
  • Create data that can help healthcare providers renegotiate payer contracts
  • Participate in external testing with healthcare payers and clearinghouses

This won't be easy and cheap. But it will help medical practices and providers prepare for ICD-10 implementation. And they will be ready if Tenant is right.

[See also: Dual coding: Why you should be assigning ICD-10 codes ASAP]

Is dual coding an unnecessary burden or strategic advantage? Let us know what you think in our very unscientific poll: Is dual coding a burden or advantage for providers?