Home Health & Hospice Week

Plus: ICD-10 will allow you to submit code letters as either upper- or lowercase, CMS confirms.

Still waiting for an announcement that perhaps ICD-10’s start date will be pushed back another year? Stop wishing and start preparing, because the ICD-10 implementation date of Oct. 1, 2014 "is firm," said CMS’s Denesecia Green during a recent CMS Open Door Forum.

To make the transition easier, CMS is offering free training sessions via phone and the web, and online tools, Green said in the Aug. 27 forum. In addition, CMS representatives aimed to dispel several common misconceptions about the new diagnosis coding program.

CMS Likens New System To Cell Phone Transition

The ICD-10 transition may seem daunting, but shouldn’t be, said physician Daniel J. Duvall in an ICD-10 webinar published by CMS. "Physicians deal in diagnoses, not codes," CMS’s Duvall said. "Coders … look up diagnoses and find the associated code. If the phone book changed from one land line per family to one cell phone per person, would you be afraid to use the phone book? That’s what’s happening in the ICD world," he said.

To support that statement, Duvall aimed to ease coders’ fears by reminding them that "An index of diagnoses is still an index of diagnoses, and the good news is that just as cell phones spawned contact lists, speed dialing, internet lookups and circles of friends, ICD-10 is spawning a new generation of coding apps — inexpensive office aids that help you find the code for your diagnosis, and maybe simplify claim preparation at the same time."

Check Your Software ForCoding Change Readiness

Timeline: Right now, you should be confirming that your software can handle ICD-10, Duvall told providers. Next spring, your clinicians and coders should develop your ICD-10 coding skills, and by next summer you should be filling out sample claims with ICD-10 just to familiarize yourself with it, he added.

Contrary to popular belief, you won’t be expected to report a vast number of diagnosis codes on your claims once ICD-10 is implemented, said CMS’s Pat Brooks on the webinar. "The ICD-10 codes are more precise. Therefore, one ICD-10-CM code may provide more detailed information than one ICD-9-CM code." For instance, Brooks said, a single ICD-10 code will capture a type of femur fracture and also the fact that it involves the left femur.

Upper/Lowercase is not important: Many coders have questioned whether the letters in ICD-10 (such as "x") must be reported as either upper or lowercase characters, with some fearing that claims will be denied if the character is reported as the wrong case, but Brooks dispelled that myth. "It is not mandatory that the alpha characters be reported as either upper or lower case," Brooks said. "Either is acceptable."

Don’t Fear Costs

In addition, providers that have been worried about nearly bankrupting their organizations due to the ICD-10 conversion should take heart, Duvall said. Realistic IT costs for ICD-10 conversion when it comes to claims processing software will depend on your specific situation, with the following variables, Duvall claimed:

• If you use paper claims, there will be no IT cost;
• If you use a free claim entry software program, there will be no IT cost;
• If you use a third-party claim entry system, the software cost depends on your system, but those with subscription or leased services will already have the cost of annual updates built into your subscription;
• If you purchased a claim entry system, you will face additional costs if you have an older system, since you’ll need to upgrade it. "However, that cost is not necessarily large," Duvall said. In addition, he said, the added benefits of automation inherent to the new system will help you reduce staff time in other areas and improve productivity.
  

Non-IT costs

You’ll also need to invest in new ICD-10 books and training for your staff members to streamline your ICD-10 conversion, Duvall said.

Plus: Clinicians who fear having to write reams of additional documentation to support ICD-10 codes needn’t worry. Only clinicians who document poorly to begin with will have problems, he claimed. For example, physicians who don’t write down whether they treated the right or the left leg "will need to change that," he said.

Note: For more information on ICD-10, subscribe to Eli’s Home Health ICD-9/ICD-10 Alert at www.aapc.com/codes/coding-newsletters/my-homehealth-icd-9-alert