7 Things Providers Should Know and Do for Transitioning to ICD-10
If you are covered by the Health Insurance Portability Accountability Act (HIPAA), and all medical providers are, then you will be required to transition to ICD-10 on October 1, 2014. Now is the time to begin the planning process. The process to transition will vary depending on the type of organization you are. Here are 7 things you should know and do as you plan for the ICD-10 transition.
1. WHY THE CHANGE TO ICD-10?
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 ICD-9 is 30 years old, has outdated terms, and does not reflect the advances in medical knowledge and technology in today’s current medical practice. With ICD-10 additional detail will help distinguish diagnosis. With ICD-9 you may have required additional documentation to explain the treatment for a claim. The greater specificity will help reduce the need for additional documentation and will also allow codes to be added and incorporated much more quickly to reflect the advances in medicine.
- Greater specificity, reducing need for additional documentation, or use combination codes
- Flexible code structure, making it easy to accommodate new codes
2. ICD-10 CODE CHANGES ARE DIFFERENT FROM THE ANNUAL CODE CHANGES TO ICD-9
ICD-10 codes have a completely different structure from ICD-9 codes, therefore the impact is much greater and a transition plan will minimize disruption to your practice.
The following provides a comparison to describe the differences in the diagnosis code set
|ICD 9||ICD 10|
The following provides a comparison to describe the differences in the procedure code set
Note, this change does not affect Current Procedural Terminology (CPT) codes, which will continue to be used for office and outpatient services.
3. TIMING OF YOUR TRANSITION IS VERY IMPORTANT TO THE PROCESSING OF INSURANCE CLAIMS.
The word “transition” is about your preparation to fully use ICD-10 prior to October 1 2014. You may not use the ICD-10 codes until the compliance date. On October 1 the light switch is flipped.
- Claims for all services and hospital inpatient procedures performed on or after the compliance deadline must use ICD-10 diagnosis and inpatient procedure codes. (This does not apply to CPT coding for outpatient procedures.) Claims that do not use ICD-10 diagnosis and inpatient procedure codes cannot be processed.
- Claims for services and inpatient procedures performed before the compliance date must use ICD-9 codes.
Continue to use ICD-9 diagnosis codes for services and inpatient procedures performed through September 30, 2014. All services or inpatient procedures performed on or after the compliance date of October 1, 2014 must use ICD-10 diagnosis codes.
4. CREATE A PLAN TO TRAIN YOUR STAFF
Training for your staff should begin about six months before the compliance deadline. Training varies for different organizations. CMS projects to plan 16 hours for coders and 50 hours for inpatient coders. The significant difference in hours reflects the difference in use. Physician practice coders will need to learn ICD-10 diagnosis coding only, while hospital coders will need to learn both ICD-10 diagnosis and ICD-10 inpatient procedure coding.
5. REQUEST AN ICD-10 COMPLIANCE PLAN FROM YOUR VENDORS
Check with your billing service, clearinghouse, practice management, and EMR/EHR vendors to learn what their compliance plans and timelines are. The vendor should be able to provide answers to the following.
- Will an upgrade to software be required to accommodate ICD-10?
- How will your product accommodate both ICD-9 and ICD-10 as you work with claims during the window of transition?
- Will there be a cost to upgrading the software?
- When will the system be ready for testing ICD-10?
- Will training or support be provided?
See ZH OpenEMR ICD-10 FAQ for answers to these questions.
6. COORDINATE WITH PAYERS AND ASSESS THEIR READINESS
If you work with a Billing Services company, request a plan for how they will be working to ensure a smooth transition. If you do your own in-house billing, request from your payers their plan for to be readied to process claims with ICD-10 codes. Your payers should be able to provide answer to the following:
- Where is your organization in the transition process?
- Will we need to test with you? If so, when will you be ready to test transactions from my practice?
- Do you anticipate any changes in policies or delays in payments as a result of the switch to ICD-10
7. BEGIN YOUR PLANNING EFFORTS NOW.
The impact of the IDC-10 transition will be felt by the majority of organizations in the health care industry, from large national health plans to small provider offices, laboratories, medical testing centers, hospitals, and more. Organizations that begin their planning efforts now will have the greatest ICD-10 success and lower the impact and potential disruption of the transition. Taking the time to plan now will save your organization time, money and frustration as the industry leads up to the October 1, 2014 cutover.
- Implementation of an EHR System: What does it look like?Sep 12 , 2019
- Unified Patient Record(UPR): Why You Should Care about ItAug 22 , 2019
- Benefits of an Integrated EHR and Medical Billing SystemAug 01 , 2019
- Federally Qualified Health Centers(FQHCs) and EHR AdoptionJul 08 , 2019
- Integrated Care EHR and the Need for Offline ModeApr 26 , 2019
- G-Code Breakers for FQHCs: Does your EHR qualify?Apr 24 , 2019
- Cloud Based EHR software for Clinical Care in Emerging CountriesSep 18 , 2018
- 3 Major Issues with Immunization Records Management (and How an EHR Can Help)Nov 13 , 2017
- The messaging feature: an ode to cognitive design in EHROct 20 , 2017
- Cloud Based EHR Software: the Key to Shielding Hospitals from Natural DisastersSep 13 , 2017
- MACRA and EHR: Seamless Integration Improves Care QualitySep 08 , 2017
- EHR Workflow: 4 Qualities You Need to SucceedAug 25 , 2017
- Cloud Based EHR Without Internet: the Offline Capabilities RevolutionAug 23 , 2017
- How long can you wait for your EMR to be Back On-Line?Aug 14 , 2017
- What’s the deal with MIPS?Aug 04 , 2017
- Decoding Meaningful Use For Your EHR SystemFeb 24 , 2017
- Web Based Electronic Health Records SoftwareFeb 21 , 2017
- What is the Difference Between an EHR and EMR?Feb 16 , 2017
- What is Certified EHR, and Why is it Important?Jan 13 , 2017
- How Can EHR Improve Patient Care?Oct 21 , 2016
- Critical Roles for EMR Training SuccessSep 20 , 2016
- How to Know if Your EMR Training Was a SuccessSep 15 , 2016
- How to Estimate EMR Training CostsSep 08 , 2016
- Why EHR Training is Crucial for SuccessSep 05 , 2016
- Best Practices in EMR TrainingAug 31 , 2016
- Why Does an EHR System Cost So Much?Aug 29 , 2016
- Trends Impacting EHR CostsAug 23 , 2016
- Understanding the High Cost of EHRJul 11 , 2016
- Understanding the High Cost of EHRJul 11 , 2016
- Understanding EHR Pricing ModelsJul 07 , 2016
- EHR Optimization Benchmarks Your Practice Should Be UsingJul 01 , 2016
- The Positive Impact of Customizing Your EHRJun 20 , 2016
- The Pros and Cons of Customizing Your EHRJun 16 , 2016
- Want EMR Success: Start with Your ProcessesJun 10 , 2016
- What does practice leadership have to do with your EHR?Jun 07 , 2016
- Why EHR Customization MattersJun 01 , 2016
- Your Data Has Value Outside of Your EHRMay 26 , 2016
- Who Owns the Data in Your EHR?May 21 , 2016
- Should You Test Your EHR Data Backup and Restore Process?May 16 , 2016
- Migrating Your EHR DataMay 10 , 2016
- Lessons to be Learned in EMR ImplementationMay 04 , 2016
- How to Avoid the EMR Patient Data Ownership Trap ?Apr 30 , 2016
- Keep Your Staff HIPAA Compliant with these 12 Best PracticesJan 30 , 2016
- A customized Health IT software for InternistsNov 03 , 2015
- Why physicians should implement electronic health records soonOct 20 , 2015
- Access to Medical RecordsOct 08 , 2015
- How to get ready for ICD-10?Sep 30 , 2015
- Save time & money by checking insurance eligibility of patientsAug 25 , 2015
- Gain control of no-shows and protect your bottom lineApr 22 , 2015
- One simple way to improve patient collections by 50%Mar 17 , 2015
- 3 Big HR Mistakes practices make when adopting an EMRJan 23 , 2015
- What is an Electronic Health Solution?Jan 19 , 2015
- What is EHR Interoperability? How Does it Benefit your Practice?Apr 22 , 2014
- How long can you wait for your EMR to be Back On-Line?Apr 22 , 2014
- The IT Benefits of Cloud Based EHRsApr 22 , 2014
- 5 Revenue cycle management Issues that could be Injuring your PracticeApr 22 , 2014
- TIPs for Choosing a Customizable EMR to fit your PracticeApr 22 , 2014
- 3 Common Mistakes That Can Scuttle Your EHR ImplementationApr 22 , 2014
- What’s the Difference between EMR and EHR?Apr 22 , 2014
- 3 Essential elements improve medical billing CollectionsApr 22 , 2014
- 32 Million Reasons you need an EMR Now!Apr 22 , 2014
- Vendor Selection is only the First Step of EMR Success!Apr 22 , 2014
- The 4 Big EHR Implementation Challenges Small Practices Face!Apr 22 , 2014
- 5 Signs that You need a New Billing Services Provider!Apr 22 , 2014
- Top 4 Reasons Small Medical Practices consider New EMR Solutions!Apr 22 , 2014
- Top 4 features Health Care Providers are looking for in their next EHRApr 22 , 2014
- 7 Things Providers Should Know and Do for Transitioning to ICD-10Apr 22 , 2014
- 3 Criteria for Selecting a Billing Services ProviderApr 22 , 2014
- The ZH Patient Portal gives Patients the Advantage!Apr 22 , 2014
- Why Your Practice Should be Using a Patient PortalApr 22 , 2014