ICD-10 Implementation Set for October 1, 2014

ICD-10 Implementation Set for October 1, 2014

With less than a year to go, 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. 


The transition to ICD-10 is occurring because ICD-9 produces limited data about patients’ medical conditions and hospital inpatient procedures. ICD-9 is 30 years old, has outdated terms, and is inconsistent with current medical practice. Also, the structure of ICD-9 limits the number of new codes that can be created, and many ICD-9 categories are full.  Diagnosis coding under ICD-10 uses 3 to 7 digits instead of the 3 to 5 digits used with ICD-9 codes.   


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.  


Here are some helpful tips to consider for the transition into ICD-10:

·         Assign an individual or committee for overall managing and decision making into the transition

·         Review internal policies making sure to support the transition

·         Identify commonly used ICD-9 codes and begin to explore related ICD-10 codes—make a crosswalk or reference for staff

·         Schedule training for billers, CSRs, intake, clinicians, managers, and other key staff


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. 




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

Are you ready to transition to ICD-10 on October 1, 2014? MLNConnects™ videos on the CMS YouTube Channel can help you prepare.