Home Health ICD-9/ICD-10 Alert

Published on Tue Jun 22, 2010 PDF

Providers who don't make the transition won't get paid, vendors warn.

Are your ICD-10 preparation plans on the back burner? The Centers for Medicare & Medicaid Services says it's time to turn up the heat.

Although the ICD-10 utilization deadline isn't until Oct. 1, 2013, CMS continues its stand that preparation now will prevent desperation in 2013. To that end, CMS has introduced a free service that allows you to receive an e-mail notification whenever the information on its ICD-10 page is updated. So when the agency announces an ICD-10 webinar, transcript, article, or tip sheet, you'll get a notification via e-mail to check the site for more information.

Most recently, the site posted an executive summary of its April 27 ICD-10 vendor conference. Despite confidence in their readiness, vendors expressed concern "that there is no testing period for ICD-10 prior to the Oct. 1, 2013 implementation deadline." Vendors were eager to hear about what the payers are doing to prepare for ICD-10, because any snags on the MAC side could slow payments to providers.

In addition, vendors noted that medical providers -- particularly those in small- to mid-sized organizations -- aren't focusing on ICD-10 yet. But the vendors strongly felt that providers should prepare now for the transition, because "if you do not comply, you will not be paid."

CMS has also posted 10 new frequently asked questions about ICD-10. One of the FAQs stresses that providers need to be ready by the Oct. 1, 2013 deadline.

"There will be no delays and no grace period," CMS says in FAQ 10020.

When you're working out your plan to move from ICD-9 to ICD-10, don't expect to do it in one leap, warns a recent report.

"It's not practical to cut over to the new coding system all at once," advise authors Daryl Dickhudt, Paul Steinichen, and Jordan Battani in the report, "ICD-10 Implementation: Objects on the Horizon Are Closer Than You Think." The report, produced by technology consulting firm CSC based in Falls Church, Va, predicts that "Health care organizations can expect an extended transition period during which they will have to support both ICD-9 and ICD-10 coding systems."

Developing a migration approach for transition to ICD-10 could easily overwhelm an agency with the magnitude of the effort that's required, the authors note. The study concludes that organizations that take a balanced approach to planning that includes the following will have the best results:

• Identify systems and processes that will be affected by ICD-10 implementation to include in the migration plan and schedule them effectively.
• Carefully evaluate vendor and internal approaches to ensure compatibility and alignment with the migration approach. This is especially important when it comes to developing, maintaining and enhancing crosswalks.
• Get commitments and schedules from vendor resources and from internal resources.
• Use a scheduled release approach to help the organization minimize the impact of timing gaps and scheduling conflicts.
• Identify gaps and develop contingency plans for potential failures in the transition plan.

CMS' FAQs are at www.cms.gov/ICD10 -- select the "Medicare Fee-for-Service Provider Resources" link on the left side of the page, scroll down the page to the "Related Links Inside CMS" section, and select "ICD-10 FAQs."

For more information on ICD-10, visit www.cms.gov/ICD10/02b_Latest_News.asp.

The CSC report is available in PDF format at http://assets1.csc.com/health_services/downloads/CSC_ICD_10_Implementation.pdf.