Pathology/Lab Coding Alert

Expect deadline to stay the same.

If you’re still holding out hope for another ICD-10 implementation delay, give it up. The date to start using the new code set — Oct. 1, 2014 — “is firm,” said CMS’s Denesecia Green during an Aug. 27 CMS Open Door Forum.

To make the transition easier, CMS has started offering free training sessions to practices via phone and the web, and will offer an online ICD-10 tool within the next few weeks, Green said. Read on to see how CMS dispels several common misconceptions about the new diagnosis coding program.

Switch with Ease Using Training and Tools

The ICD-10 transition may seem daunting, but shouldn’t be, said CMS’s Daniel J. Duvall, MD in an ICD-10 webinar published by CMS on Aug. 28. “Physicians deal in diagnoses, not codes,” Duvall said. “Coders, and physicians, when they code their own claims, 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 [similar to] 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

Right now, you should confirm that your software can handle ICD-10, Duvall said. Next spring, your physicians and coders should develop ICD-10 coding skills, and by next summer you should be filling out sample claims with ICD-10 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: If the pathology report for an appendix specimen identifies concretions, ICD-10 provides a specific code for the condition: K38.1 (Appendicular concretions). Under ICD-9, on the other hand, you would report a less-specific code: 543.9 (Other and unspecified diseases of appendix).

Don’t Fear Costs

If you’ve heard that your new IT costs will be sky-high due to ICD-10, you could be in for a pleasant surprise. Most of those IT costs were already incurred by your practice to convert to using the new 5010 transaction standard.

Realistic claims processing IT costs for ICD-10 conversion will depend on your specific situation, with the following variables, Duvall noted:

• 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. He added that physicians who fear having to write reams of additional documentation to support ICD-10 codes needn’t worry. Only physicians who document poorly to begin with will have problems. Otherwise, coders should be able to easily select codes based on the doctor’s documentation.

Learn more: You can access CMS resources for ICD-10 transition at www.cms.gov/Medicare/Coding/ICD10/ProviderResources.html.