Preparing for ICD-10

Pamela Tran, CHCN’s Certified Coder

by Pamela Tran

After several delays, the Centers for Medicare & Medicaid Services (CMS) is sticking firm to the ICD-10 CM implementation date of October 1st, 2014. ICD (International Classification of Diseases) CM (Clinical Modification) codes are used nationwide by coders, billers, and physicians when completing claim forms for reimbursement of medical services provided. All CHCN health centers are currently operating with ICD-9 CM codes but there are several big changes with the 10th version and advanced planning is needed to ensure a smooth transition in October 2014.  Here are a few steps that clinics may want to do now to help prepare for the upcoming changes.

  1. CROSSWALK:  Run a frequency report for the most commonly used diagnosis codes and create a crosswalk from the current ICD-9 CM codes to the equivalent ICD-10 CM codes.
  2. DOCUMENTATION:  Because of ICD-10 CM codes specificity, health plans and carriers are saying they may not reimburse unspecified codes.  Providers should get in the habit of writing detailed notes now to assist coders and billers with selecting the correct billing code once ICD-10 CM goes live.
  3. STUDY: ICD-10 CM codes require more detailed knowledge of anatomy and physiology terminology. Now is the time to brush up on that information.
  4. PREPARE YOUR SYSTEMS:  Ask your EHR vendor and/or clearinghouses if your system is ICD-10 CM ready and, if not, how your system will be updated with the new codes to prepare for the big change in October 2014. For example, ICD-10 CM will allow up to 7 characters per code, up from 5 characters with ICD-9 CM.

For more information on preparing for ICD-10 CM please visit the CMS website, www.cms.gov/Medicare/Coding/ICD10/ProviderResources.html. You can also contact CHCN’s Certified Coder, Pamela Tran, at ptran@chcnetwork.org with questions.