Scary stories from Canada, dire warnings from the AMA, and a stream of experts alternately comforting providers and warning them to hunker down and prepare for the worst are leaving providers confused and conflicted a mere seventeen months before ICD-10 implementation on October 1, 2014. In response to the jumbled avalanche of information hitting providers at a time when the industry is in the midst of several massive changes, the Centers for Medicare and Medicaid Services (CMS) has developed a fact sheet identifying several myths about ICD-10 and clarifying the truth behind these common misconceptions.
Myth: Not everyone has to switch to ICD-10
Fact: All HIPAA-covered entities, including physicians and hospitals, are mandated to switch to ICD-10 in 2014. But that doesn’t include every single type of organization that currently uses ICD-9. Worker’s Compensation and auto insurance companies, for example, use ICD-9 codes but are not required to make the leap to ICD-10. But it’s in their best interests to do so, says CMS, since physicians and hospitals will be using the newer codes. The increased detail and specificity will be just as useful for worker’s comp as it is for the emergency department, and CMS will work with non-covered entities to help them make the transition. State Medicaid Programs will also receive CMS help to ensure that they will meet the deadline.
Myth: Everything is going to get prohibitively more complicated
Fact: ICD-10 has a lot of codes. 140,000 of them, to be exact. But just as increasing the number of words in a dictionary doesn’t make it harder to use, the greater number of ICD-10 codes won’t significantly affect the complexity of coding, CMS explains. Electronic decision support tools and organized code books will make finding the right code easy, and the new logical structure of ICD-10 will help coders find exactly what they’re looking for.
Non-specific codes are still available for use if supported by clinical documentation, and much of the detail necessary for ICD-10 coding is already present. Providers do not need to perform unnecessary diagnostic tests just to get to the most specific code that exists in the code book. Superbills based on ICD-10-CM won’t necessarily be any longer or more complicated than ICD-9 superbills, and codes can be crosswalked to help the conversion process.
Date: May 28, 2013