Prepare Now for ICD-10 Coding Change
Medical coding is an important skill for office managers and staffers in U.S. healthcare organizations. Understanding the requirements of Medicare, Medicaid and private insurers is essential for obtaining reimbursement for providers’ services and maintaining an effective revenue cycle management (RCM) program.
With that in mind, physician groups and other providers are preparing for a major change in the coding for medical diagnoses and inpatient hospital procedures on October 1. That’s when implementation tenth version of the International Classification of Diseases, or ICD-10, is scheduled to occur. The current version, ICD-9 has been in place for more than 35 years and contains many outdated and obsolete terms, according to the Centers for Medicare & Medicaid Services (CMS).
This summer, CMS is working with the American Medical Association (AMA) to help providers prepare for the changes, including webinars, on-site training, educational articles and other educational programs for physicians and back-office staffers. CMS’ free help includes the “Road to 10” aimed specifically at smaller physician practices with primers for clinical documentation, clinical scenarios, and other specialty-specific resources to help with implementation.
“With easy-to-use tools, and a new ICD-10 ombudsman, CMS is committed to helping the physician community to work through this transition,” said Andy Slavitt, CMS acting administrator. “As we work to modernize our nation’s health care infrastructure, the coming implementation of ICD-10 will set the stage for better identification of illness and earlier warning signs of epidemics.”
Slavitt said the use of ICD-10 should advance public health research and emergency response through detection of disease outbreaks and adverse drug events, as well as support innovative payment models that drive quality of care.
In response to providers’ requests, CMS is releasing additional guidance that will allow for flexibility in the claims auditing and quality reporting process as the medical community gains experience using the new ICD-10 code set.
“We appreciate that CMS is adopting policies to ease the transition to ICD-10 in response to physicians’ concerns that inadvertent coding errors or system glitches during the transition to ICD-10 may result in audits, claims denials, and penalties under various Medicare reporting programs,” said AMA President Steven J. Stack, MD. The AMA also has a broad range of materials available to help physicians prepare for the October 1 deadline.
Clearly, now is the time for providers to train their office staffers and make a smooth transition to this major change in reimbursement procedures.