Preparation for ICD-10

The October 1, 2014 ICD-10 deadline is getting closer, and implementation can no longer be overlooked.  The Centers for Medicare and Medicaid (CMS) have announced that there will be no more delays.  If your facility isn’t fully prepared for the transition to ICD-10, now is the time to act.

While there are some similarities between the ICD-9 and ICD-10 codes, there are several changes that were noted on today’s national provider call with CMS that will impact all users in every health care setting.  The following list offers a few notable changes:

The level of detail and specificity has been expanded.

  • The affected body side has been added to relevant codes.
  • Injuries are now grouped by anatomical site.
  • Modern medicine and updated terminology are more clearly reflected.
  • Addition of a 7th character in certain chapters allows for even more precision.
  • The placeholder “X” will be used in some codes:
    • Either for codes containing less than 6 digits where a 7th character applies,
    • Or in preparation for future expansion.
  • Exclusion notes have been expanded to two types:
    • Excludes1 notes indicate conditions that cannot occur together.
    • Excludes2 notes indicate conditions that are not represented in the same code and can be reported together using additional codes.

The transition from ICD-9 to ICD-10 will be beneficial in a multitude of ways including more efficient tracking of public health and risks, prevention and detection of healthcare fraud and abuse and reduced coding errors.  However, the change will not be effortless and requires strategic planning.  Services provided after the compliance deadline has passed will be denied if not accurately billed with the new code set.

To access the official CMS ICD-10 implementation guidance go to the following link:

HC Healthcare Consulting has extensive expertise in coding and billing compliance. Our staff includes certified coders, consultants certified in healthcare compliance, and certified public accountants that are available to provide expert assistance with your ICD-10 implementation efforts, including physician and staff documentation and coding training.  We are also available to assist with your ongoing compliance needs.

DISCLAIMER:  This post contains only summary information and highlights; it should be read in conjunction with the full article or document provided as a link.  Any advice or recommendations given is general and specific questions should be directed to professional counsel.

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