ICD-10 Compliance Step 1

Get Ready Now with the New CMS Quick Start Guide!

While ICD-10 is almost here, you still have time to get ready. But you must get ready now.

This week CMS is highlighting the 5 steps from the new Quick Start Guide: 1) Make a Plan, 2) Train Your Staff, 3) Update Your Processes, 4) Talk with Your Vendors and Health Plans, and 5) Test Your Systems and Processes. The focus of this article is:

Step: 1 Make a Plan

• Assign target dates for completing steps outlined here. 
• Most important, obtain access to ICD-10 codes. The codes are available from many sources and in many formats: 
  • Code books 
  • CD/DVD and other digital media 
  • Online (e.g., go to cms.gov/ICD10 and select “2016 ICD-10-CM and GEMS” to download 2016 Code Tables and Index) 
  • Practice management systems 
  • Electronic health record (EHR) products 
  • Smartphone apps 
• Decide role(s) your clearinghouse(s) will play in your transition. Some providers who are not ready could benefit from contracting with a clearinghouse to submit claims: 
  • Clearinghouses can help by: 
    • Identifying problems that lead to claims being rejected 
    • Providing guidance about how to fix rejected claims (e.g., more or different data need to be included) 
  • Clearinghouses cannot help you code in ICD-10 codes unless they offer third-party billing/coding services

Tips

• You must use: 
  • ICD-10 codes for all services provided on or after October 1 
  • ICD-9 codes for all services provided before October 1 
• Identify everywhere in your practice that you use ICD-9 codes to make sure you know what processes and systems need to be updated for ICD-10; for example: 
  • Patient registration and scheduling 
  • Clinical documentation/health records 
  • Referrals and authorizations 
  • Order entry 
  • Coding 
  • Billing 
  • Reporting and analysis 
• Even clearinghouses that offer coding and billing services cannot translate ICD-9 codes to ICD-10 codes unless they have the detailed clinical documentation required to select the right code 
• Practices that do not prepare for ICD-10 risk disruptions in cash flow 
• For a more in-depth approach to planning, see the Action Plan section of the Road to 10

To learn more about getting ready, visit cms.gov/ICD10 for free resources including the Road to 10 tool designed especially for small and rural practices, but useful for all health care professionals.

Keep Up to Date on ICD-10
Visit the CMS ICD-10 website for the latest news and resources to help you prepare. Sign up for CMS ICD-10 Industry Email Updates and follow CMS.gov on Twitter.