The change from ICD-9 to ICD-10 is approaching. On October 1, 2013 all HIPAA transactions will require the use of ICD-10 codes. Your claims and other transactions may be rejected if you are not using the new codes. This could result in delays and may impact your reimbursements, so it is important to start now to prepare for the changeover.
What Is ICD-10?
ICD-10 is the next generation of the international diagnostic coding system created to replace the outdated ICD-9 code set. In the United States the term ICD-10 is actually referring to ICD-10CM, The United States Clinical Modification of the World Health Organizations (WHO) original ICD-10 coding.
Why Is It Changing?
The simple answer is the current coding system ICD-9 has run out of room. Medical science has advanced greatly since the creation of the ICD-9 codes. Computer technology, combined with new, more detailed codes of ICD-10 will allow for better analysis of disease patterns and treatment outcomes that can advance medical care. These same details will streamline claims submissions, since these details will make the initial claim much easier for payers to understand.
The Difference Between ICD-9 And ICD-10
ICD-9 and ICD-10 are similar in many ways. They both follow the same rules and guidelines very closely. What differentiates them from each other is the ICD-10’s detailed coding. Going from 13,000 codes to 71,000 will allow for better record keeping. ICD-10 format is expanded from 5 to 7 digits and also now incorporates letters, not just numbers in the codes. This change will affect information technology in your practice. Software applications will need to change to accommodate the new 7 digit codes. The framework for transmitting claims is also being updated from HIPAA 4010a to HIPAA 5010.
What is HIPAA 5010?
The format in which electronic claims and remittance use is know as HIPAA 4010a. To accommodate the ICD-10 change over, the standards for electronic health care transactions will be changing to HIPAA 5010. The move from the current version 4010A to version 5010 must be completed by January 1, 2012. Not transmitting electronic health care transactions using HIPAA 5010 after January 1, 2012 will result in denials and delays in your revenue cycle. The good news is that you can make the change at any time prior to January 1, 2012, this will allow you to spend the time to properly test the software changes and ensure your claims are being received and paid properly.
Technology Is Key
Attempting the change to ICD-10 coding will be nearly impossible on paper charts and charge tickets. Physicians will now have five times as many codes to choose from and billing staff will need more access to the medical chart to ensure the proper codes are used. Having a solid EHR and practice management (billing) software platform in place will be critical. On average, the implementation, from purchase to fully optimized use can take 12-18 months. To be ready for the change in October of 2013, you should be working on your EHR implementation now.
When Should I Start Preparing For The Change?
Today. The earlier you prepare your staff and office technology, the easier the conversion will be. The first step is to implement the software and technology that will be your tools through this change.
We Can Help
The potential of having to update software installations, staff training, changes to business operations, internal and external testing, and reprinting of manuals and other materials can be overwhelming. Our team of Medical Practice Technology Specialists can help. By creating a clear transition plan we will prepare you for the challenges ahead.