In October 2014 ICD-10 will take effect as the nation’s official coding system.
The Centers for Medicare & Medicaid Services (CMS) has mandated the ICD-10 diagnosis code set for use by physician practices, other providers, clearinghouses and health plans. With ICD-10 containing more than five times the number of codes as ICD-9 and incorporating a completely different structure, the new code set will require extensive changes for medical groups.
DuxWare will accommodate ICD-10 codes on October 1, 2014. Everyone covered by the Health Insurance Portability and Accountability Act (HIPAA) must transition to ICD-10 on October 1, 2014, including providers and payers who do not deal with Medicare claims.
Users will input ICD-10 codes into DuxWare via EMR charge message dropped into the Incoming Claim Manager or by manual charge entry for practices without EHR. We are expecting our clearinghouse partners to provide a listing of Payers that will be ICD-10 ready for 10/1/2014. If a payer is not ICD-10 ready, or is not required to accept ICD-10 codes, there will be an option in the DuxWare Payer Set up to cross-walk the ICD-10 code selection to the corresponding ICD-9 code set.
What can you do?
We recommend that your office and clinical staff take advantage of all educational venues that are afforded to you to get yourself ready for the transition.
Be pro-active in contacting your EMR, Clearinghouse, and DuxWare. If you have questions or concerns, the DuxWare Support Team will be glad to assist you.
Take advantage of ICD-10 training opportunities that are afforded to you. If you are not on the e-mail list with CMS for ICD-10, sign up for their email messages. Click to follow this link http://www.cms.gov/Medicare/Coding/ICD10/CMS_ICD-10_Industry_Email_Updates.html. CMS has resources to help providers prepare for a smooth transition to ICD-10. Visit www.cms.gov/ICD10 to find out more. CMS will continue to add new tools and information to the site through the course of the transition.
Identify ICD-9 touch points in your office and with affiliate business processes. If an ICD-9 code touches a document or process now, an ICD-10 code will affect it in a greater way on 10/1/2014. Review all correspondence and form materials for impact of ICD-10 (E.G. lab forms, encounter forms, assessment forms, etc.) Can you code for ICD-10 with your current documentation? Additional training in physiology and anatomy may be needed. Ascertain what you need to change to be ICD-10 ready. Having the ICD-10 ready forms and documents ready well in advance of 10/1/2014 will decrease the potential for negative impact on your office and clinic work flow.
Hard copy Encounter Form (or SuperBill)vs. EMR: It is expected that clinics who utilize an EMR (Electronic Medical Record) that is bridged to a Practice Management System such as DuxWare will suffer less of an impact as those clinics that do not have an EMR. Clinics that rely solely on encounter forms for billing their services will see an explosion of diagnosis codes to display on the encounter form due to the specificity of the ICD-10 codes. Encounter forms will be in excess of 9 to 11 pages if physicians are to include ICD-10 codes on their forms. Exploding the Encounter Form to accommodate the display of ICD-10 codes is not an efficient or cost effective option. It is our recommendation that providers use a common sheet with their most frequently used codes to select the correct ICD-10 for the services provided to the patient. Get a list of your top 20 diagnosis codes. You can obtain the list from the Reports Tab in DuxWare:
Select the date range for about one year:
Below is an example of ICD-9 code: 727.42 cross-walked to ICD-10 from ICD-10 CodeSearch
DuxWare will be fully functional and ready to accept input of ICD-10 codes on October 1, 2014. We are prepared and will begin testing with our clearinghouse partners in the spring of 2014. We will keep you informed.