by Carl Natale
Posted on Sat, Sep 07, 2013 - 08:57 am
I'm not a fan of ICD-10 codes as punchlines because they tend to be the basis of anti-ICD-10 arguments. Those are the arguments that tend to be light on substance.
Sometimes we have some instructional posts that rely on the unique diagnoses to make learning about the ICD-10 code sets more fun.
I don't believe those attempts to make learning fun are ammunition for anti-ICD-10 forces. Opponents are finding diagnoses to ridicule all on their own. (They probably didn't do much more research beyond reading an old Wall Street Journal.)
My advice to Kristi Swanson is to lighten up. Or keep looking for fun ways to teach healthcare professionals about ICD-10 coding.
CMS-1500 Claim Form Updates: Medicare to Accept Revised Form Starting January 2014
The CMS-1500 Claim Form has been recently revised with changes including those to more adequately support the use of the ICD-10 diagnosis code set. The revised CMS-1500 form (version 02/12) will replace version 08/05. The revised form will give providers the ability to indicate whether they are using ICD-9 or ICD-10 diagnosis codes, which is important as the October 1, 2014, transition approaches. ICD-9 codes must be used for services provided before October 1, 2014, while ICD-10 codes should be used for services provided on or after October 1, 2014. The revised form also allows for additional diagnosis codes, expanding from 4 possible codes to 12.
Only providers who qualify for exemptions from electronic submission may submit the CMS-1500 Claim Form to Medicare. For those providers who use service vendors, CMS encourages them to check with their service vendors to determine when they will switch to the new form.
Medicare will begin accepting the revised form on January 6, 2014. Starting April 1, 2014, Medicare will accept only the revised version of the form.
It probably doesn't shock to learn that ICD-10 implementation could keep John D. Halamka, Chief Information Officer of Beth Israel Deaconess Medical Center, awake. But it is interesting what specifically goes through his head:
"Will ICD10 proceed on the October 1, 2014 timeline? All indications in Washington are that deadlines will not be changed. Yet, I'm concerned that payers, providers and government will not be ready to support the workflow changes required for successful ICD10 implementation."
It's pretty much inevitable that healthcare providers will see a slow down in reimbursements. There are steps to prepare:
- Focus on education so your staff knows how to document and code properly.
- Know your payers' policies.
- Create procedures and methods for recoding denied claims.
- Prepare to track the causes of rejections and denials.
How hospitals can keep their revenue cycles from stalling:
- Start training now.
- Expect medical coders to take longer with claims while they become familiar with the ICD-10 code set.
- Clean up your presently back-logged claims now.
- Understand how medical claims are flowing.
- CMS is rewriting the coverage determination policies. Stay on top of it.
- Prepare for denials by assigning someone to track denials and work with healthcare payers.
- What can go wrong?
- Key vendors could go out of business
- You might miss a payer in outreach
- Systems could fail
- Build a safety net.
- Train staff to be able to handle ICD-10 coding
- Participate in external testing find problems in advance.
- Build cash reserves
- Hire extra staff
Pretty much a standard post on preparing for ICD-10 implementation. But it makes an interesting point:
"The thorough process review required for ICD-10 implementation is, by itself, a benefit. The re-affirming of coding best practices is always instructive for clinicians and improved documentation should result. An accurate, complete, timely diagnosis is at the core of good, quality care. All physicians know and take pride in this."
Rhonda Buckholtz theorizes that much of the productivity loss after ICD-10 implementation will be due to improper documentation. That can lead to increased time coding medical claims and dealing with physician queries. Training and documentation improvement can lead to restored productivity within four to six months. (Physicians Practice)