San Francisco Marin Medical Society Blog

Guide to ICD-10 Transition: Steps for August



 

Physician practices have less than 75 days before the October 1 deadline to implement the ICD-10 code set. The AMA and CMS have put together a guide to ensure a seamless transition to ICD-10.

Still getting started?

If you’re still in the early stages of prepping your practice, spend the month testing your practice’s ICD-10 readiness and identify potential problems.

  • Perform content-based testing to assess your practice’s documentation and ability to code in ICD-10. In this type of testing, your practice uses documentation to code a clinical scenario in the new code set. The Healthcare Information and Management Systems Society offers resources to help your practice with this kind of testing.
  • Conduct internal testing to evaluate your practice’s ability to create and use ICD-10 codes throughout the patient work flow in place of when you currently use ICD-9 codes. This type of testing requires your practice to have system upgrades installed already and helps you follow the flow of a patient through a visit to identify the points at which codes are used. Use this testing to identify any gaps in your ICD-10 updates.
  • Do external testing to test your practice’s ability to send and receive transactions that use ICD-10 codes with your external trading partners, including your billing service, clearinghouse and payers. Check with these groups about their testing plans.

One type of external test is acknowledgement testing with Medicare, which simply acknowledges that a claim has been received. Physicians can perform acknowledgement testing with their Medicare Administrative Contractors and the Common Electronic Data Interchange contractor any time until the October 1 implementation date.

Already on your way?

Now is the time to prepare for possible disruptions in claims processing. While organized medicine (AMA, CMA, SFMS) have secured provisions and confirmed 1-year grace period from CMS to ease the transition to the new code set, physicians should still be ready, especially because private payers may not ease up their claims payment processes.

Make sure you have taken the most important steps to prevent cash flow interruptions. They are to ensure:

  • Your systems can accommodate the ICD-10 codes
  • Your staff is trained
  • You have tested thoroughly with your trading partners

If you’ve been following a solid transition plan, you should be well-prepared to handle any potential claims disruptions.

The provisions the AMA secured from CMS address claims denials, quality reporting penalties, payment disruptions and navigating transition problems. Click here to learn details of the agreement. 

Additional Resources

CMS will host a National Provider Call from on August 27, 2:30 pm to 4 pm EST (11:30 am to 1:00 pm PST). Experts will discuss coding guidance and tips, answer coding questions, and provide information about claims that span before and after the implementation date. Click here to register for the free call.

Click here to view CMS’ Road to 10 Guide implementation guide for solo/small group practices. 


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