News Updates | June 22, 2015

100 DAYS AWAY: ICD-10 Deadline October 1, 2015

Get Ready Now with the New CMS Quick Start Guide!

While ICD-10 is almost here, you still have time to get ready. But you must get ready now.

Each day this week we are highlighting 1 of the 5 steps from the new Quick Start Guide: 1) Make a Plan, 2) Train Your Staff, 3) Update Your Processes, 4) Talk with Your Vendors and Health Plans, and 5) Test Your Systems and Processes. Today our focus is:

Step: 1 Make a Plan

• Assign target dates for completing steps outlined here

• Most important, obtain access to ICD-10 codes. The codes are available from many sources and in many formats:

• • Code books

  • CD/DVD and other digital media

  • Online (e.g., go to cms.gov/ICD10 and select “2016 ICD-10-CM and GEMS” to download 2016 Code Tables and Index)

  • Practice management systems

  • Electronic health record (EHR) products

  • Smartphone apps

• Decide role(s) your clearinghouse(s) will play in your transition. Some providers who are not ready could benefit from contracting with a clearinghouse to submit claims:

• • Clearinghouses can help by:

  • • Identifying problems that lead to claims being rejected

    • Providing guidance about how to fix rejected claims (e.g., more or different data need to be included)

  • Clearinghouses cannot help you code in ICD-10 codes unless they offer third-party billing/coding services

Tips

• You must use:

• • ICD-10 codes for all services provided on or after October 1

  • ICD-9 codes for all services provided before October 1

• Identify everywhere in your practice that you use ICD-9 codes to make sure you know what processes and systems need to be updated for ICD-10; for example:

• • Patient registration and scheduling

  • Clinical documentation/health records

  • Referrals and authorizations

  • Order entry

  • Coding

  • Billing

  • Reporting and analysis

• Even clearinghouses that offer coding and billing services cannot translate ICD-9 codes to ICD-10 codes unless they have the detailed clinical documentation required to select the right code

• Practices that do not prepare for ICD-10 risk disruptions in cash flow

• For a more in-depth approach to planning, see the Action Plan section of the Road to 10

To learn more about getting ready, visit cms.gov/ICD10 for free resources including the Road to 10 tool designed especially for small and rural practices, but useful for all health care professionals.

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