ICD-10 News Stream

Centers for Medicare & Medicaid Services (“CMS”) recently launched the ICD-10 Clinical Concepts Series to acclimate providers to ICD-10 diagnosis coding. The Series focuses on specialties and includes common codes, clinical documentation tips and clinical scenarios.

On February 11, 2015, the House Energy and Commerce Committee’s Health Subcommittee held a hearing on ICD-10 implementation. The Subcommittee heard testimony from seven industry stakeholder witnesses, six of whom testified in favor of maintaining the October 1, 2015 implementation date for ICD-10.

When most practices think about the shift from ICD-9 to ICD-10, they think of changes to physician documentation, diagnosis code selection, and software upgrades. But ICD-10 is going to have a big impact on the pre-authorization process too. Here's why, and what to do about it.

Change Request (CR) 8602 was created by CMS to allow for MACs to test with a limited number of providers and clearinghouses to ensure claims with ICD-10 codes can be processed from submission to remittance.

Depending on the size of your practice or facility, ICD-10 budgeting requirements and reporting will vary. But one fact still remains: all practices must budget for ICD-10-CM implementation. Most physician-based practices utilize a cash-based accounting system, while larger facilities and hospital-owned clinics utilize accrual-based accounting. Either accounting system will require detailed attention and planning in order to implement ICD-10 successfully.

An ICD-10 budget needs to include more than the cost of new software and ICD-10 training. There are many costs that may not be obvious.

For the procrastinating physicians, it's time to figure out how ICD-10 coding will affect medical practices.The American Medical Association (AMA) covers the assessment nicely as part of its free educational resources. I found some tips from the Centers for Medicare and Medicaid Services (CMS) and created a hybrid check list.

Providers, payers and claims clearinghouses can look for no relief from the looming, Oct. 1 compliance deadline for the nationwide conversion to the ICD-10 family of diagnostic and procedural codes, the head of the CMS said Thursday. But some case-by-case exemptions will be made for providers having a tough time meeting their Stage 2 meaningful-use targets, she said.

AAPC along with the Workgroup for Electronic Data Interchange (WEDI) and the Centers for Medicare & Medicaid Services (CMS), have worked together toward formation of the ICD-10 Implementation Success Initiative. The purpose of the initiative is to ensure successful ICD-10 implementation for all healthcare industry stakeholders, including healthcare providers, payers, clearinghouses, and vendors. It will serve as a hub to field questions regarding ICD-10, and develop a coordinated education effort regarding implementation.

S: Mrs. Finley presents today after having a new cabinet fall on her last week, suffering a concussion, as well as some cervicalgia. She was cooking dinner at the home she shares with her husband. She did not seek treatment at that time. She states that the people that put in the cabinet in her kitchen missed the stud by about two inches. Her husband, who was home with her at the time told her she was “out cold” for about two minutes. The patient continues to have cephalgias since it happened, primarily occipital, extending up into the bilateral occipital and parietal regions. The headaches come on suddenly, last for long periods of time, and occur every day. They are not relieved by Advil. She denies any vision changes, any taste changes, any smell changes. The patient has a marked amount of tenderness across the superior trapezius.

Recently, a certain clinical documentation specialist asked a very thought-provoking question: What will be the impact of subspecialty physician ICD-10 training on coding practices, including issues of conflicting documentation?

Despite the differences between ICD-9 and ICD-10, the basic rules of coding will remain unchanged. In fact, trained coders will actually see a number of similarities in how the two code sets are used. The key to getting comfortable with the new code set is to understand how the expansion under ICD-10 allows for more specific codes to report laterality, episode of care, trimester and clinical details.

The CMS MLN Connects™ Call Program has a variety of online resources to get you started down the road to ICD-10 proficiency. Check out the Calls and Events web page for slide presentations, audio recordings, and written transcripts, from previous ICD-10 educational conference calls, or view one of our popular ICD-10 educational video programs. Read, listen, or view these information packed programs at your convenience to learn more about implementing ICD-10 in your workplace.