Last Minute ICD-10 Thoughts

ICD-10 is upon us.

It is almost here, yes, there will not be a delay. I have had several providers ask that question even as of last week. CMS will go easy on denials and penalties if the first three digits (first one an alpha) are used with less specificity for the first 12 months. 

No guarantee what other payers will do – advice – DIRFT, do it right the first time anyhow!

By now all should have identified the top 20 ICD-9 codes from the billing software and done your cross walk. Recommend that you have a five column spreadsheet handy:

ICD-9   |   Description   |   ICD 10   |   Description   |   Considerations

The considerations are specifics that will help with the cross walk from 9 to 10. Use this in lieu of printing new super bills, laminate several copies and have them all over the office.

Plan on no money in November and December, October should be all right. Get a line of credit and plan on no bonus this year. That may sound extreme but you never know with 650,000+ providers, multiple insurance carriers, labs, imaging centers, pharmacies, etc. all involved something will go wrong. W e hope not too much but be on the safe side.

Cross walk existing patients, those scheduled after 10/1 (remember it’s date of service driven), and new patients with ICD-9 for current billing and then you are prepared for the first visit after 10/1. Some software programs will be a big help.

For authorizations, lab orders, imaging studies, procedures, etc. that will be done after 10/1 talk with the payers NOW about how to deal with them. See who will accept ICD-10 now or when they will accept and if you have to authorize with ICD-10 or if they will allow the ICD-9 authorization that you may already have slide. Not sure I trust anyone so checking is a good idea.

Plan on reviewing your cash picture around 10/20 for Medicare payments since you will be submitting claims on Thursday 10/1 and 10/2 and payments will be made in 14 – 17 days. Plan the same for 11/4 or 5 and 11/20 for your non-Medicare payers based upon payment sequences found in your contracts (check out payment terms, interest payments, etc.

You may do well and have all your testing done, laminated copies, systems in place, providers and staff trained, if so great. Not sure about all those outside of your direct control. Therefore, be cautious and prepared for the worst and hope for the best.