Debunking ICD-10’s Three Biggest MY TH S CLARIFYING THE REALITY arlier this year, the Centers for Medicare & Medicaid Services (CMS) addressed several misunderstandings around ICD-10 in its "ICD-10-CM/PCS Myths and Facts" guide. While CMS debunked some of the most common ICD-10 myths, much of the industry is still confused about key topics, such as whether the ICD-10 deadline will once again be extended or which payors are required to transition to ICD-10. With less than a year until ICD-10 goes into effect, providers cannot waste time believing anything but the truth. Here are the facts about three of the ICD-10 myths that are still circulating, as well as some tips for helping your practice overcome these ICD-10 obstacles. Myth 1: There will be another delay to the ICD-10 implementation deadline. Cms has confirmed that there will be no more delays, but it is understandable why so many people expect one. We have already received a one-year extension from the original deadline in 2013, and much of the industry is still behind in preparation. Despite this, October 1, 2014 will remain as the official deadline, and it is important that practices are prepared to submit claims with ICD-10 codes by this date. Cms senior Technical advisor Pat Brooks confirms that “… the ICD-10 implementation date will not be delayed further.” 22 HBma BIllIng • maRCH.aPRIl.2014 With less than a year left to prepare, it is essential that you plan well to be ready for the transition. Cms has an excellent online ICD-10 guide that can help you think through your transition plan. as you are preparing, think about everywhere you currently use an ICD-9 code, and create a gap analysis so these areas can be modified for ICD-10. Training your staff for ICD-10 also will need to be a major focus, since billers and coders will need to code in the new system. Remember to include time to train your physicians and clinical staff, as they will need to know what type of documentation to provide in patient charts to help the coders identify appropriate ICD-10 codes. even with thorough planning in place, it is still possible that you will experience payment delays once ICD-10 takes effect. It is strongly recommended that your clients establish a loan or line of credit to help tide their practices over if you experience delays in reimbursement during the transition. Myth 2: State Medicaid plans are not required to transition to ICD-10. all entities covered by HIPaa will need to transition to ICD-10, and this includes all state medicaid plans. major industry changes like this are challenging for state medicaid plans due to their limited funding, so Cms is providing special assistance to help them with this massive transition. However, it is possible that some state medicaid plans will not be ready by the October 1, 2014 deadline. Other payors that are not covered by HIPaa (such as property and casualty, workers’ compensation, and auto insurance) are E By Jackie Griffin
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