ICD-10 Implementation Set for October 1, 2014

Only 6 months left until and you should be getting ready for October 1, 2014 with the transition into ICD-10.   According to CMS, there are no more delays, this date is firm.  ICD-10 will affect diagnosis and inpatient procedure coding for everyone covered by the Health Insurance Portability Accountability Act (HIPAA), not just those who submit Medicare and/or Medicaid claims.

For services provided on or after October 1, 2014, ICD-9 codes will not be accepted.  ICD-10 codes will not be accepted for services prior to October 1, 2014.   This means there is no transition period, that once October 1, 2014 arrives ICD-10 will be in effect and ICD-9 will no longer be accepted and claims will get denied.

You need to be working with your billing software company making sure that they are getting ready for this transition and to find out the steps you need to take.

CMS and the DME MACs are working on the transition and have lots of helpful information available on the websites, which are listed below.  Take advantage of these webinars and materials that are available to you making sure to educate your staff.  CMS even has free videos available which have been included with this information provided here.  The National Center for Health Statistics has available free of charge in PDF and XML format on their website.  Remember to check with your billing software company to see how the transition will work and for training they may have available.  There are also many book publishers that have the ICD-10 books and training material available.

Resources:

CMS:     www.cms.gov/ICD10

National Center for Health Statistics:  www.cdc.gov/nchs

Jurisdiction A:  www.medicarenhic.com

Jurisdiction B:  www.ngsmedicare.com

Jurisdiction C:  www.cgsmedicare.com

Jurisdiction D:  www.noridianmedicare.com

Reminders:

  • Claims will go by date of service not date billed so use the ICD-10 code for claims on or after October 1, 2014 and use ICD-9 for dates of service prior to October 1.
  • As for capped rental items, you need to change the ICD-9 code to ICD-10 for claims billed on or after October 1.  You do not need to get a new order, but make sure you are using the correct ICD-10 code in order to avoid a denial.

Medical policies and related articles will be updated by April 10, 2014.  Be sure to watch closing for these updates and to read the entire policy and article.  See below for the medical policies being affected.

The following medical policies and articles will have ICD-9 to ICD-10 translations along with a new policy/article ID number.

  • Ankle-Foot/Knee-Ankle-Foot Orthosis
  • Automatic External Defibrillators
  • External Breast Prostheses
  • Glucose Monitors
  • High Frequency Chest Wall Oscillation Devices
  • Immunosuppressive Drugs – Policy Article
  • Intravenous Immune Globulin – Policy Article
  • Knee Orthoses
  • Mechanical In-exsufflation Devices
  • Nebulizers
  • Oral Anticancer Drugs – Policy Article
  • Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) – Policy Article
  • Oral Appliances for Obstructive Sleep Apnea
  • Orthopedic Footwear
  • Osteogenesis Stimulators
  • Ostomy Supplies – Policy Article
  • Oxygen and Oxygen Equipment
  • Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea
  • Pressure Reducing Support Surfaces – Group 2
  • Pressure Reducing Support Surfaces – Group 3
  • Refractive Lenses
  • Suction Pumps
  • Therapeutic Shoes for Persons with Diabetes – Policy Article
  • Tracheostomy Care Supplies – Policy Article
  • Transcutaneous Electrical Nerve Stimulators (TENS)
  • Urological Supplies
  • Wheelchair Seating
  • VED – DRAFT