Please be advised of
the following
information distributed by
CMS - Centers For Medicare & Medicaid Services
Practices preparing for the
October 1, 2014, ICD-10 deadline are looking for resources and
organizations that can help them make a smooth transition. It is
important to know that while clearinghouses can help, they cannot
provide the same level of support for the ICD-10 transition as they
did for the Version 5010 upgrade. ICD-10 describes a medical
diagnosis or hospital inpatient procedure and must be selected by the
provider or a resource designated by the provider as their coder, and
is based on clinical documentation.
During the change from Version
4010 to Version 5010, clearinghouses provided support to many
providers by converting claims from Version 4010 to Version 5010
format. For ICD-10, clearinghouses can help by:
- Identifying problems
that lead to claims being rejected
- Providing guidance
about how to fix a rejected claim (e.g., the provider needs to
include more or different data)
Clearinghouses cannot, however,
help you identify which ICD-10 codes to use unless they offer coding
services. Because ICD-10 codes are more specific, and one ICD-9 code
may have several corresponding ICD-10 codes, selecting the
appropriate ICD-10 code requires medical knowledge and familiarity
with the specific clinical event.
While some clearinghouses may
offer third-party billing/coding services, many do not. And even
third-party billers cannot translate ICD-9 to ICD-10 codes unless
they also have the detailed clinical documentation required to select
the correct ICD-10 code.
As you prepare for the October 1,
2014, ICD-10 deadline, clearinghouses are a good resource for testing
that your ICD-10 claims can be processed-and for identifying and
helping to remedy any problems with your test ICD-10 claims.
ECP plans to send periodic updates
with suggestions on implementing ICD-10 into your practice. This will
be a crucial change to healthcare, and working now toward the change
will only help the transition!
Please
contact ECP for questions
800-327-1213
