For services provided on and after October 1, 2015, U.S.-based entities covered under the Health Insurance Portability and Accountability Act (HIPAA) are required to use ICD-10 code sets. ICD-9 codes will no longer be accepted on claims for services provided on or after October 1, 2015. ICD-10 consists of two parts:
- ICD-10-CM diagnosis coding which is for use in all U.S. health care settings.
- ICD-10-PCS inpatient procedure coding which is for use in U.S. hospital settings.
Medscape recently reported that nearly a quarter of physician practices say they will not be ready for the ICD-10 implementation deadline on October 1, 2015, while another 25 percent say they are unsure whether they’ll be ready. The latest Workgroup for Electronic Data Interchange survey also found that only about 20% of physician practices have started or completed external testing.
ICD-10 will have a substantial impact on you and your practice however, you can mitigate some of the impact by developing an action plan and preparing your practice now. You should also know that you will have some flexibility in coding during the first year after the implementation of ICD-10. While you will be required to use valid ICD-10 codes for services performed on and after October 1, 2015, Medicare claims will not be denied solely because the ICD-10 code submitted wasn’t specific enough as long as the code is from the appropriate family of ICD-10 codes. Coding to the highest level of specificity should be the goal for all claims, however, during the first twelve months after ICD-10 implementation, Medicare will process valid ICD-10 codes from the appropriate family of codes in most circumstances. (See the “Grace Period” section of this newsletter for more information.)
In this ISASS newsletter, you will:
- learn ICD-10 basics;
- learn how to prepare your practice for the transition to ICD-10;
- learn what the “grace period” means for you and your practice;
- have access to ICD-9 to ICD-10 crosswalks of commonly used spine codes; and
- learn where to go to access additional resources.
Additionally, mark your calendar for a National Provider Call on ICD-10 hosted by CMS on Thursday, August 27 from 2:30-4:00 p.m. ET. You can register for the call titled “Countdown to ICD-10” at the following link: