At Ware Langhorne & Associates, we are committed to assisting our clients with the transition to ICD-10 effective October 1, 2015. We have implemented an ICD-10 team to train on the requirements needed to make the transition from ICD-9 to ICD-10 as painless as possible. This ICD-10 Implementation Team has been in training for several months now. We have been taking courses to learn the nuances of the transition and what it will mean to all aspects of your business.
ICD-10 will replace ICD-9 on October 1, 2015. ICD-9 encompassed approximately 13,000 codes, ICD-10 will consist of approximately 68,000 codes. The standard code structure will change from code lengths of 3-5 characters used for ICD-9 to code lengths of 3-7 characters for ICD-10. As I am sure that you are aware, the only ICD-9 codes that involved an alpha character were the "V" codes and the "E" codes. In ICD-10, all codes will begin with an alpha character. The format of the ICD-10 book is very much the same as in ICD-9, codes are still grouped based on the disease processes of the different anatomical systems. What is the reason for the "explosion" of the amount of codes? ICD-10 places much more emphasis on the specificity and laterality in the code selection. For example, when a patient presents for knee pain, ICD-9 really only has 1 code for that problem. ICD-10 actually classifies it into 3 codes, 1 for each knee and a code for "unspecified" knee.
Who will be affected by these changes?...Everyone will be affected.
- Front office staff will be affected due to the need to provide the correct ICD-10 code when it comes to referrals, authorizations, etc.
- Physicians will be affected due to the need of being more specific in their medical record documentation to coordinate and support their more specific coding.
- Physicians will be affected due to the need to specify and provide the correct ICD-10 codes on their charge tickets so billing can include it on the claims for proper processing and reimbursement
- Insurance payers will be affected with new edits that have to be made to their systems for proper claim adjudication.
- Clearinghouses will also have new edits to accommodate the new codes.
- Software vendors will have to manage their systems for all of these changes.
What will happen on October 1, 2015?
There will be a period of "dual use" of both sets: ICD-9 and ICD-10 based on the date of service.
- DOS of 09/30/2015 and before will require the use of ICD-9 codes.
- DOS of 10/1/2015 and after will require the use of ICD-10 codes.
Start Preparing Now
- Physicians should start changing documentation habits now, being more specific documenting diseases based on ancillary information, lab / radiology results, laterality / site location of problems, etc.
- During early 2015 Ware Langhorne & Associates will distribute ICD-10 "cross-walks" so physicians can start familiarizing themselves with the ICD-10 codes they will most commonly use
Beginning in the months of April Ware Langhorne & Associates will begin providing training to both our physicians as well as our front office staff; training resources will continue over the 6 month period April through September in preparation on the October 1 start.
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