Although the ICD-10 transition officially went into effect last year on October 1st, 2015, a grace period was put into place by the Centers for Medicare & Medicaid Services (CMS). October 1, 2016, will mark the end of a one-year “grace period” that allowed unspecified ICD-10-CM codes on certain physician Medicare claims as well as the end of a three-year partial code freeze. Here's what your practice can do now to prepare.
What Does the End of the ICD-10 Grace Period Mean for Your Practice?
The end of the ICD-10 grace period means that, in a matter of weeks, all physicians in the U.S. will be expected to code in ICD-10 with a high level of proficiency and specificity.
Those who can't will likely experience a high number of rejections and denials starting soon after the end of the grace period on October 1, 2016.
"There will be 1,943 new codes, 422 revised codes and 305 "invalid" codes, which will have additional digits to further classify them."
With October 1st coming quickly, there isn't much time left before the grace period ends. Even if your practice is fully prepared for the transition, getting used to the new coding standards will likely result in slower processing times.
There are a few things you can do to make the transition period smoother for your practice, as well as for patients and third parties.
According to AHIMA, your practice should focus on three key areas to prepare for October 2016:
Lee also stresses the importance of hiring a credentialing coding professional to evaluate code assignments, identify software errors, and conduct advanced ICD-10 training for non-specific documentation and coding problem areas.
If hiring a full-time coding professional is out of your budget, you may want to consider bringing in a temporary coding consulting or considering outsourcing your revenue cycle management.
Another critical step in preparing for the end of the ICD-10 grace period is checking your EMR software. Lee states that "since the 2015 CMS and AMA announcement regarding unspecified ICD-10 codes, physician practices have tended to maintain the status quo—relying on EMR software to suggest correct ICD-10 codes."
Check your EMR software to see if any glitches could be causing coding errors leading to claims rejections and reimbursement delays.
If you haven't already taken advantage of the many online training sessions available and/or hired someone to provide training on-site, then you may want to consider it.
Practices should have clear procedures in place to meet the ICD-10 coding guidelines, in addition to a plan to provide thorough training on an on-going basis for the new coding methods and regulations.