Pediatric Coding Alert

But Medicaid plans will not give you an extension past Oct. 1, 2014, the agency stresses.

If you’re biding your time waiting for the ICD-10 date to be pushed back another year, you can stop wishing and start testing your diagnosis coding program, because the Oct. 1, 2014 date is firm. That was the word from CMS’s April 18 webinar, “Begin Transitioning to ICD-10 in 2013,” which covered various ICD-10 hot topics and provided answers to many pressing questions.

CMS will be done creating its computer system work so it can process ICD-10 codes by this October, giving the agency a full year of testing before you actually submit ICD-10 codes next year, said CMS’s Sarah Shirey-Losso during the call.

Start Internal Testing ASAP

If your practice is currently wondering whether you should be taking any steps to transition to ICD-10 right now, CMS’s Denesecia Green has the answer. “We’re asking everyone from now through the end of the year to start your internal testing,” she advised.

You cannot, however, submit your claims to your Medicaid provider yet for testing, because the Medicaid payers are not prepared to handle that. If you want to test a claim using ICD-10 codes with your payers, contact the payer for guidelines on how to do that, said CMS’s Stewart Streimer during the call. “Other than that, there will not be end-to-end testing. CMS has already got a vigorous testing plan in place to test our ability to handle a properly filled out claim from the front end to the back end. But we will not be testing claims from providers.”

Auto Accident, Worker’s Comp Patients May Require ICD-9

Although Green stressed that “everyone—Medicare, Medicare Advantage, Medicaid—all industry will have to transition from ICD-9 to ICD-10,” that may not include certain payers that handle your car accident or worker’s compensation patients’ claims.

Automobile accident and worker’s compensation insurers will not be required to implement ICD-10, Green said. Although some auto insurance payers will transition to ICD-10, others may not, so you’ll unfortunately have to contact your individual auto and worker’s compensation insurers for details on how they’d like you to bill effective Oct. 1, 2014.

Keep in mind that since CMS will not be updating ICD-9 going forward, auto and worker’s compensation insurers that steadfastly refuse to adopt ICD-10 will eventually come up short on available codes as new diagnoses are introduced or revised and ICD-9 does not update, said CMS’s Pat Brooks during the call. “So I don’t know how long worker’s comp or auto insurers could viably keep mandating ICD-9-CM, since we will not maintain ICD-9-CM any further.”