International Classification of Diseases, Version 10 (ICD 10) Update

There are a couple of key issues regarding ICD-10 that everyone should consider but before we get to actual recommendations lets cover some basic information such as:

  • What is ICD 10?
  • Who must comply with ICD-10?
    billing codes
    ICD 10 transition
  • Will there be another delay in the future?
  • What should I do?

What is ICD 10? ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO).  In other words, ICD 10 is a medical classification list used by health care professionals to categorize patient illnesses, conditions or reasons to receive services. Who must comply with ICD 10? Based on the Centers for Medicare and Medicaid Services (CMS) everyone covered by the Health Insurance Portability Accountability Act (HIPAA) must comply with ICD-10.  I don’t necessarily agree with CMS on this and instead I will phras e it as anyone that provides medical services after its implementation and wishes to receive payment from a commercial insurance, State or Federal Payor. Will there be another ICD 10 implementation delay in the future?  As of the time of this article implementation date continue to be October 1st, 2015.  However, Congress may change that as part of the Medicare’s Sustainable Growth Rate formula fix.  So far no legislation has been drafted but there is plenty of talk about the subject. What should I do?  I will strongly recommend to start any ICD 10 implementation efforts with CMS online resources, Road to 10. In addition to that I will also consider the following three key steps:

  1.  Locate the most commonly billed ICD-9 codes:
  2. Convert those ICD-9 codes into ICD-10 codes: There are several free tools on the market to facilitate this task such as:
  3. Conduct a documentation audit: This is very important as Providers must make sure that their present documentation standards meet the requirement of medical specificity.  There is a lot to this particular topic for which additional research and training is recommended.
  4. Get a line of credit.  No matter how effective is your billing staff or company, there is a high probability that payments will be delayed.  So rather than stress out for the lack of liquid assets I recommend getting a line of credit now so you will not be tight later.

Regardless of what the Government decides to do I encourage everyone to get ready now as the time between now and October is not that far away.