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Highlights from the January 12 ICD-10 call

During the January 12 Preparing for ICD-10 Implementation in 2011 National Provider Teleconference, CMS provided listeners with a wealth of information to help them prepare for the October 1, 2013 implementation of this new coding system. Some highlights from the call are as follows:

  • There will be no delays or grace periods. Providers will not be able to continue to report ICD-9-CM codes for services provided on or after October 1, 2013 and there will be no delays in implementation date of ICD-10. Also, ICD-10 codes will not be accepted for services prior to October 1, 2013.
  • All providers in every healthcare setting will use ICD-10-CM (diagnoses), but only hospitals will use ICD-10-PCS (procedures) for inpatient hospital procedures.
  • General Equivalence Mappings (GEMs) assist in converting data from ICD-9-CM to ICD-10. But GEMs may not be the best option for everyone and they certainly are not a substitute for learning how to code with ICD-10.
  • There will be a partial code freeze to make the transition process a little easier for vendors, trainers, and providers. This means that:
    • The last regular, annual updates to both ICD-9-CM and ICD-10 will be made on October 1, 2011.
    • On October 1, 2012 there will be only limited code updates to both ICD-9-CM & ICD-10 code sets to capture new technology and new diseases.
    • On October 1, 2013 there will be only limited code updates to ICD-10 code sets to capture new technology and new diseases.
    • On October 1, 2014 regular updates to ICD-10 will begin.
    • The public will comment on whether new codes should be created during the freeze.
  • CMS has a variety of online resources to help providers prepare and transition to ICD-10. Links to these resources are included in the slide presentation.

But perhaps the most important take-away from today’s call was that providers need to start preparing for ICD-10 implementation sooner, rather than later.

“Providers that start training and planning for ICD-10 implementation early can expect a smoother transition,” said Sue Bowman RHIA, CCS, director of coding policy and compliance at the American Health Information Management Association.

Bowman provided an ICD-10 preparation process and timeline to help guide facilities. A brief overview of this preparation process, which is broken down into phases, is as follows:

  • Phase 1: Implementation plan development and impact assessment (1st quarter 2009 – 2nd quarter 2011)
  • Phase 2: Implementation preparation (1st quarter 2011 – 2nd quarter 2013)
  • Phase 3: “Go live” preparation (1st quarter 2013 – 3rd quarter 2013)
  • Phase 4: Post-implementation follow-up (4th quarter 2013 – 4th quarter 2014)

“It is critically important to get started on these steps if you have not already done so,” said Bowman, who also outlined some consequences of poor preparation:

  • Increased claims rejections and denials
  • Increased delays in processing authorizations and reimbursement claims
  • Improper claims payment
  • Coding backlogs
  • Compliance issues
  • Decisions based on inaccurate data

For more information about what was covered in the call, refer to the slide presentation.