ICD-10 Grace Period Ends 10-1-16
Good day e-MDs practices. Last year this time, there was a tremendous amount of anxiety over ICD-10. Is my EMR ready? Are the clearinghouses going to receive my claims properly? Will there be a slowdown in reimbursement? As a company, Solor was ready. We extensively trained our staff for the 6 months leading up to ICD-10. We had spoken to our clearinghouse contacts and felt good in our testing protocols leading up to the transition. We provided webinars to our clients giving them additional education. Everything was ready. October 1 came and went. Our clients had a very successful transition. Hooray!!
We are now on the edge of the what our company calls ICD-10 2.0. You may recall, as part of the transition, Medicare agreed to give providers 12 months to get more familiar ICD 10 coding. As long as the codes being used were in the correct “family” of codes they would accept the codes and pay for services rendered. That grace period ends on 10/01/2016. If the practice isn’t careful, you may start receiving many more denials with this code- CO16: LACK OF INFORMATION Dx RELATED.
In terms of code changes, we have: 1943 New codes, 305 deleted codes, 422 revisions. There are quite many tabular notes and guideline changes in:
* Use additional code
A sample code change is for Zika Virus.
As of now, the best code we could use for Zika Virus is A92.8 “Other specified mosquito-borne viral fevers”— which includes “Zika (viral)” in its list of fevers . As of 10/01/2016 we will have a new code: A92.5 Zika virus disease
Chapter 4 Endocrine, nutritional and Metabolic ( E00-E89) including diabetes.
There are 260 new codes with new diabetes combination codes that you’ll need to be familiar with.
Chapter 18 R00-R99 added new code R73.03 “prediabetes” This was a much needed code for a long time. Doctors have used this dx for years making it hard for coders to find anything since we don’t code rule outs. This will be a good change.
Chapter 19 has 885 new codes– increased site specificity for fracture codes, critical for orthopedists and others who use X-rays.
Chapter 20 External causes of morbidity (V00-Y99) A number of changes here that you’ll want to look at.
Then there are the always humorous ones that are added. An important code for all of us that work in offices…..W26.2XX Contact with edge of stiff paper (paper cut)
Finally, you’ll need to watch for 7th character especially when it comes to:
A: initial encounter
D: Subsequent encounter
ICD-10 version 2.0 is coming in 2 weeks. We predict the amount of denials for practices that haven’t focused on education will increase by 300% or more. It’s never too late to get started educating your team. As always, let us know if we can be of any assistance if you have questions about this blog or have other questions about billing workflow. Simply fill out the form below.
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