06 Oct Being Compliant with ICD-10 is Essential
Physicians, medical practices, medical billing and coding companies, and anyone who utilizes ICD codes will be busy in 2015 as the new coding system, ICD-10, replaces the former system, ICD-9. The new coding system is to be implemented by all medical providers and those associated with such starting October 1. 2015. Preparing for this rollout is time consuming and labor intensive. It involves utilizing new software, a coding system that has been expanded from 14,000 unique medical diagnosis codes to 68,000, and a huge amount of training.
Confusion and Mistakes
It’s anticipated by the American Medical Association (AMA) that the new coding system will result in a large number of errors on the part of physicians, billers and coders, and insurance providers. The new codes are very specific and using the wrong code can result in delayed payments, rejected claims, and insurance audits. The AMA has asked for a two-year grace period to protect hospitals and physician practices that implement a new medical classification system. What’s at stake? That would be over $2.8 trillion in medical bills and payments.
ICD-10 is Extremely Specific
No one argues that the new coding system is not needed. But with close to five times as many codes as before and various new sets and subsets of codes, the implementation is intimidating and daunting. In this B2B exchange of information required to secure payments for services rendered, involving medical practitioners, billers and coders, and insurance providers, there’s a lot that can go wrong.
An example of one change from ICD-9 to ICD-10 has to do with arthroscopy, which did not exist in 1978 when the old codes were first used. Along with adding such a code, ICD-10 defines when an endoscope is used to perform minimally invasive surgery on a joint. And it also has separate codes for whether a procedure is an initial one or a subsequent treatment.
There are specific and separate codes for injuries suffered when attacked by a squirrel, sucked into a jet engine, or stabbed by a crochet needle. And although those seem as if they might not be used often, if a physician is treating a broken ankle, a much more common injury, there are a series of codes that must be properly identified. These include the correct ICD-10 code for which leg the ankle is situated, as well as which side the injury is on, that is if it’s on the lateral or medial side, and whether the injury involves a fracture that is closed or open.
Compliance is Complicated
Thus, it can be seen that that compliance with ICD-10 will be complicated but necessary. There is no turning back despite the fact that AMA would like a grace period. If your medical billing and coding company is not up to speed on the new codes, and if you as someone in the medical field providing services are unable to make the necessary adjustments, then the result can be delays in processing and loss of payment. Being compliant starting on October 1, 2105, will be necessary for you and your practice.
MPMR is a top medical billing and coding company who can help your practice get a hold of ICD 10 and make the transition seamless. This is what separates MPMR from other billing companies, the top notch service and additional skill set with consulting and operations assistance.
Call MPMR today!