An overview of ICD-10: what you need to know

The transition has been years in the making — the implementation of ICD-10 codes. This tenth revision of International Classification of Diseases, known as ICD-10, marks a big change in the way HIPAA-covered providers and payers will code healthcare services.

The advantages of transitioning from the current system, ICD-9, to ICD-10 include clinical, operational, professional and financial benefits. ICD-10 codes allow for greater specificity in describing patients’ diagnoses and providers’ chosen procedures and treatments. And they reflect current medical methods as well. The new coding will also align better with performance-based payment systems and help ensure more accurate billing.

Under the ICD-10 system, healthcare providers have access to 69,000 diagnosis codes, which are up to seven digits long to accommodate for greater complexity and specificity. In comparison, ICD-9 includes only 14,000 codes of three to five digits and with limited ability to specify laterality, severity and other measures.

Due to new legislation (Protecting Access to Medicare Act of 2014) enacted on April 1, 2014, the previous deadline for compliance of October 1, 2014, was pushed back a year to October 1, 2015, at the earliest. Despite the delayed deadline, Online Reputation Management a recent survey of physicians from across the nation found that 73 percent of respondents will continue moving forward with preparations as planned or on an adjusted timeline.

And survey respondents’ reactions to the postponement varied depending on where providers currently are in the process of getting ready to use ICD-10. Thirty-one percent said they are disappointed with the delay because they’re ready for the new system, while 34 percent said they would have been ready this year but appreciate the extra time to further prepare. More than 20 percent are frustrated because they’re concerned physicians will now put off training. And 13.5 percent are happy with the delay because they wouldn’t have been ready by the original October 2014 compliance date.

If you were working toward the previous deadline of October 1, 2014 in settlement advice, the yearlong delay gives your practice a chance to assess your readiness and make adjustments. Though the postponement may cause you to incur extra costs, look at the additional time as an opportunity to complete more training and testing. You now have a larger window of time in which to address any issues and more time to work with vendors and payers to ensure all systems, transactions and processes work correctly.

Of course, some preparations will now need to be pushed off until closer to the new implementation date. For example, it makes sense to complete certain types of training later on, so it will be fresh in the minds of physicians and staff when it comes time to actually use the codes. But be sure to use the extra time wisely and plan to keep working toward the transition, adjusting your timeline as needed.

If your practice is significantly behind, you should think of this delay as great motivation to take action. Here’s your chance to get going on your plan! Review how the ICD-10 codes will affect your processes, technology and workflow. Update your timeline, assign tasks, assemble resources and communicate with your staff, vendors and payers to make sure everyone is on the same page.

This latest delay may be a source of frustration or disappointment to some practices. But for those with a lot of preparations left to complete, it’s also a great opportunity to catch up.

 

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