How your clearinghouse can help with the ICD-10 transition

Carl Natale
by Carl Natale
How your clearinghouse can help with the ICD-10 transition

Clearinghouses exist because medical billing has become more complicated than treating disease. And ICD-10 implementation won't simplify it. So can clearinghouses can simplify the ICD-10 transition?

How clearinghouses will NOT help with ICD-10 implementation

Clearinghouses are not going to assign ICD-10 codes to medical claims for physician practices. That is up to the practice to do. Medical practices still will need proper training and documentation.

They cannot help  identify which ICD-10 codes to use unless they offer coding services and have access to clinical documentation. Nor will they convert ICD-9 claims to ICD-10 claims.

How clearinghouses CAN help with ICD-10 implementation

Right now, some clearinghouses can start testing with medical practices. This is valuable because clearinghouses are working with many healthcare payers and providers. When they find one problem and solve it, they can help other clients fix or avoid the same issue.

Clearinghouses are medical billing experts who can offer valuable ICD-10 transition advice.

How to tell IF clearinghouses can help with ICD-10 implementation

Medical practices should be asking questions

  • Are you prepared to meet the ICD-10 deadline of Oct. 1, 2015?
  • Where is your organization in the transition process? (They should be ready by now.)
  • Who will be the primary contact for the ICD-10 transition?
  • Can we set up regular check-in meetings to keep progress on track?
  • What are your plans for ICD-10 testing?
  • When will you begin accepting ICD-10 test claims?"
  • Can you provide clinical documentation guidance or training to support the specificity required for ICD-10 coding?
  • Will prices change because of the ICD-10 transition?

Remember, clearinghouses can help process medical claims. They cannot convert your ICD-9 coded medical claims into ICD-10 coded claims.