How to make a successful transition to ICD-10-CM

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HHS sets Oct. 1, 2015 deadline for ICD-10 implementation

The U.S. Department of Health and Human Services (HHS) issued a rule finalizing Oct. 1, 2015 as the new compliance date for healthcare providers, health plans, and health care clearinghouses to transition to ICD-10. The deadline was delayed to allow providers, insurance companies, and other stakeholders additional time to implement ICD-10, which restructures the diagnosis classification system with a significant increase in the number of codes, expanded code lengths, and narrative descriptions, allowing for greater granularity. Dermatology alone is moving from 9,000+ ICD-9 codes to more than 22,000 codes in ICD-10. For additional information about ICD-10, visit http://www.cms.gov/Medicare/Coding/ICD10/index.html.

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Q: What changes can I expect when using the new ICD-10-CM codes?

A: ICD-10-CM is not just an update of ICD-9-CM codes. It is a restructuring of the diagnosis classification system with a significant increase in the number of codes, expanded code lengths, and narrative descriptions, allowing for greater granularity. Dermatology alone is moving from 9,000+ ICD-9-CM codes to more than 22,000+ codes in ICD-10-CM.

Q: When is the ICD-10-CM compliance deadline?

A: The compliance deadline for ICD-10-CM is Oct. 1, 2015. All Health Insurance Portability and Accountability Act (HIPAA)-covered entities with transactions that have dates of service on or after Oct. 1, 2015 must be submitted using ICD-10-CM.

Q: What does ICD-10-CM compliance mean?

A: ICD-10-CM compliance means that all HIPAA-covered entities must implement ICD-10-CM for use in standard electronic transactions (including but not limited to claims) for health care services provided on or after Oct. 1, 2015.

Q: Who is affected by the transition to ICD-10? If I don’t deal with Medicare claims, will I have to transition?

A: Everyone covered by HIPAA must use ICD-10-CM starting Oct. 1, 2015. This includes health care providers and payers who do not deal with Medicare claims. Organizations that are not covered by HIPAA, but use ICD-9-CM codes should be aware that their coding may become obsolete if they do not transition to ICD-10-CM.

Q: What happens if I don’t switch to ICD-10-CM?

A: If you don’t transition to ICD-10-CM, all your claims for all health care services performed on or after Oct. 1, 2015, will not be processed, therefore risking claim denials.NOTE: Claims for services provided before Oct. 1, 2015, must use ICD-9-CM diagnosis codes.