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Novitas Reminds us of the Impending ICD-10 Transition Date: October 1, 2014

(February 7, 2014):  The upcoming ICD-10 transition is only a little more than six months away! Earlier today, Novitas Solutions, Inc. (Novitas) re-issued the Centers for Medicare and Medicaid Services’ (CMS’) article on “Medicare Fee-For-Services (FFS) Claims Processing Guidance for Implementing International Classification of Diseases, 10th Edition (ICD-10).” A copy may be found here. As most health care providers, suppliers, and billers are aware, effective October 1, 2014, all individuals and entities covered under the Health Insurance Portability and Accountability Act (HIPAA) are required to use the ICD-10 codes to code claims that fall under the ambit of HIPAA.

October 1, 2014 is a total transition date. That is, ICD-9 codes will no longer be accepted for any claims with dates of service or discharge on or after October 1, 2014. Notably, a claim cannot contain both ICD-9 and ICD-10 codes. Claims that continue to use ICD-9 codes for health care services rendered on or after October 1, 2014 will be returned to the respective provider as unprocessable. Until then, all claims for dates of service preceding October 1, 2014 must use ICD-9 codes, making the transition rather abrupt. All trials with ICD-10, therefore, must be worked out with internal teams and business trading partners in the interim.

Of course, the rules surrounding ICD-10 codes are very different and the codes are much more specific as compared to ICD-9. The concern for all those subject to HIPAA is how to quickly and smoothly make the transition from ICD-9 to ICD-10. CMS recognizes the daunting nature of this task and has prepared various educational materials for providers. CMS has also proffered recommendations, including the following:

  • Establish an ICD-10 transition team or project coordinator;
  • Develop a plan for making the ICD-10 transition;
  • Determine how the ICD-10 transition will affect your organization;
  • Review how ICD-10 will affect clinical documentation requirements and electronic health record (EHR) templates;
  • Communicate the plan, timeline, and new system changes and processes;
  • Secure a budget;
  • Talk with your payers, billing and IT staff;
  • Coordinate your ICD-10 transition plans; and
  • Talk to your trading partners about testing.

In regard to training, the American Health Information Management Association (AHIMA) recommends that training begin no more than six to nine months before the October 1, 2014 transition deadline. The time is now.

Healthcare LawyerLorraine Ater, Esq. is a health law attorney with the boutique firm, Liles Parker, Attorneys & Counselors at Law.  Liles Parker has offices in Washington DC, Houston TX, McAllen TX and Baton Rouge LA.  Our attorneys represent health care professionals around the country in connection with government audits of Medicaid and Medicare claims, licensure matters and transactional projects.  Need assistance?  For a free consultation, please call: 1 (800) 475-1906.



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