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CMS Considers ICD-10 Test Run A Success

ICD 10 Success

With less than a month to go until the October 1 deadline for implementation of ICD-10 codes, many providers are nervous and wary of the readiness of the Centers for Medicare and Medicaid Services (CMS) systems.

According to CMS, there is little to worry about. CMS recently released the results of its July ICD-10 end-to-end testing and announced a success rate of 87%.

Approximately 1,200 voluntarily providers participated in the test.  

  • Of the 29,286 test claims received, 25,646 were accepted. (This is an 87% success rate.)
  • 1.8% of the test claims were rejected due to invalid submission of ICD-10 diagnoses or procedure codes.
  • 2.6 % of test claims were rejected due to invalid submission of ICD-9 diagnosis procedure code.  
  • Zero rejects due to front-end CMS issues.

If you are a provider, these statistics should be comforting. However, the 13% error rate is still a cause for concern. Add that number to that fact that the ICD-10 codes will have 68,000 diagnosis and procedure codes FIVE times the number of ICD-9 codes, and it can be a bit overwhelming.

Remember that that upon implementation, ICD-10 codes will be required for all HIPAA covered entities.  

Please contact Kimberly Sheridan at ksheridan@jeylaw.com or 678-708-4702 if you have questions about ICD-10 implementation.

ICD-10 Deadline Less Than 3 Months Away – Need Help?

CMS Announces Measures To Help Ease Transition

The countdown to the ICD-10 has begun in earnest, and the Centers for Medicaid & Medicare Services (CMS) has made it clear that it will not back down on the deadline of October 1, 2015. However, CMS announced on July 6, that it is adopting policies to help ease the transition to ICD-10.

The ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code. 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 or Medicaid claims.

Although the American Medical Association (AMA)  has long opposed the ICD-10 conversion, it issued a joint press release with CMS on July 6. The press release addresses some of the AMA’s concerns and offers some concessions by CMS. To assuage concerns from healthcare providers about inadvertent coding errors that could lead to audits and penalties, CMS has named a CMS ICD-10 Ombudsman to triage and answer questions about the submission of claims. The ICD-10 Ombudsman will be located at CMS’s ICD-10 Coordination Center. CMS has also released provider training videos and an outline of its implementation plan.

Additionally, CMS has announced that for one year past the Oct. 1, 2015, deadline, it will reimburse for incorrectly coded claims as long as that erroneous code is in the same broad family as the right one.

Providers should note that claims for services provided on or after the compliance date will need to be submitted with ICD-10 diagnosis codes; but claims for services provided prior to the compliance date should be submitted with ICD-9 diagnosis codes.

It is important for providers to have their practices ready to implement ICD-10 on October 1, 2015. If you need help with the ICD-10 transition and implementation, call Jeyaram & Associates’ Kimberly Sheridan at 678-708-4703.

ICD-10 Deadline for Healthcare Providers Fast Approaching – Jeyaram & Associates Can Help

ICD DeadlineThe October 1, 2014 deadline to switch to the ICD-10 codes set is less than five months away. This mandatory requirement replaces the ICD-9 codes set used to report medical diagnoses and inpatient procedures.

All healthcare providers covered by the Health Insurance Portability Accountability Act (HIPAA) must adhere to this new requirement. Please note, the change to ICD-10 does not affect CPT coding for outpatient procedures and physician services.

All healthcare practices currently using the ICD-9 codes must transition to the new codes. The transition to the new codes set will take several months. If you have not started the transition, we strongly urge to begin now. 

ICD consists of two parts:

1. ICD-10-CM for diagnosis coding
2. ICD-10-PCS for inpatient procedure coding 

ICD-10-CM is for use in all U.S. health care settings. Diagnosis coding under ICD-10-CM uses 3 to 7 digits instead of the 3 to 5 digits used with ICD-9-CM, but the format of the code sets is similar.

ICD-10-PCS is for use in U.S. inpatient hospital settings only. ICD-10­ PCS uses 7 alphanumeric digits instead of the 3 or 4 numeric digits used under ICD-9-CM procedure coding. Coding under ICD-10-PCS is much more specific and substantially different from ICD-9-CM procedure coding.

The Centers for Medicare and Medicaid Web site provides detailed check lists to help healthcare providers make the transition. However, if you have questions or need help with the transition to the ICD-10 codes set, Jeyaram & Associates can help. Contact DJ Jeyaram at DJ@Jeylaw.com or 678-708-4705.

 

Healthcare Providers Unprepared for New ICD-10 Codes

ICD-10 CodesAccording to the latest edition of Georgia’s Department of Community Health’s newsletter, most healthcare providers are not ready for the conversion for the ICD-10 Code set.

ICD-10 survey* says most providers are ill-prepared!

  • 62% of Georgia physicians have not begun to prepare for the conversion to ICD-10 Code Sets.
  • 83% said that they have either been too busy with other priorities to embrace and implement ICD-10 or are unaware of where to start and what they need to do.
  • 11% know ICD-10 is coming but don’t think it will be difficult to handle.

*Physician Survey of ICD-10 Awareness and Readiness, Medical Association of Georgia and the Department of Community Health (2/2013)

DCH is offering a free Webinar on March 26, 2013, to help providers prepare. Visit http://dch.georgia.gov/icd-10 for more information