| You've probably heard that the mandated switch to | | | | the new version of HIPAA transaction standards |
| using ICD-10 codes for filing claims has been delayed | | | | known as 5010 in order to file claims. This is due to the |
| by a few years until October 2013. You can breathe a | | | | fact that the current 4010 version does not |
| little easier for now, but you may want to consider | | | | accommodate ICD-10 codes. Even if you believe you |
| how your office will implement the changes now. And | | | | can put off updates to switching to ICD-10, you should |
| what do these changes mean for your practice? | | | | at the very least start considering what it will take to |
| First, some background...as you know, medical | | | | update to the 5010 transaction standards. |
| insurance companies do not pay for "tension | | | | According to a recent article in the Wall Street Journal: |
| headaches" and "15 minute office visits for an | | | | "CMS says it expects implementation of the new |
| established patient" - insurance companies pay for | | | | system initially will boost by as much as 10% the |
| ICD-9 codes like 307.81 and procedure CPT codes | | | | number of claims returned because of coding |
| such as 84450. ICD-9 codes, procedure and HCPCS | | | | mistakes. But a study by the Blue Cross and Blue |
| codes all describe patient complaints, illness, | | | | Shield Association of insurers predicts billing errors are |
| procedures and supplies for a submitted claim. The | | | | likely to rise between 10% and 25% in the first year." |
| ICD-9 codes currently in use were adopted in the | | | | It may be a good time to consider either a switch to |
| 1960s by the U.S. Since then there have been many | | | | outsourcing your billing to pass the cost off to a billing |
| advances in the medical industry. Under the current | | | | company, or at least consider an internet based claims |
| ICD-9 system, the room to expand is limited. By adding | | | | filing program. The advantages with internet based |
| room under the new system, there will be space to | | | | electronic claims filing is that the updates are built in to |
| expand and it will allow for more specific reporting. | | | | the platform at no cost to you other than the cost of |
| How much so? Think there are a lot of codes now? | | | | using the service. This could potentially save you |
| Try 68,000 diagnoses codes, up from 13,000 ICD-9 | | | | thousands upfront as well as over the long run. The |
| codes now. For procedure codes we go from 3000 | | | | whole purpose of the switch to ICD-10 is to |
| codes now to 87,000 codes! What is more, ICD-9 | | | | accommodate the increasing updates in technology |
| codes will go from up to 5 digits (ex. 307.81) to up to 7. | | | | and procedures. You can be sure that any in-house |
| The deadline for implementation is 2013. In fact, this is | | | | software you use for claims filing will require annual |
| not the first time ICD-10 was supposed to be | | | | updates that can represent cost to your practice as |
| implemented. Many medical providers have put off | | | | well. |
| switching taking a wait and see approach since the | | | | You can see why it will be more important then ever |
| mandate has been delayed in the past. However, this | | | | to have a coder educated on the new codes as a |
| time is different as insurers have begun to put | | | | part of your practice. Implementation of the new |
| processes in place in preparation. | | | | system will be costly, so when the time comes, |
| If you now do your billing in-house and file using on-site | | | | out-sourcing your coding could be a cost-saving |
| software, the switch to ICD-10 could be a large | | | | solution. If that is the route you choose, there are |
| expense for updates to your software as well. What's | | | | physician billing services that can assist you. |
| more, by January 1, 2012 all physicians must begin using | | | | |