Hurrah for the healthcare industry! There is news that the Centers for Medicare & Medicaid Services (CMS) is looking into pushing the implementation date for ICD-10 further into the future. Part of the reason for this change of heart has been the issues that have arisen due the transition to the new 5010 transaction set, that is necessary to convert to ICD-10. The change to ICD-10 is scheduled to take effect October 1, 2013.

ICD10 Medical Billing Services

ICD10 Medical Billing Services

There has been a whole new industry that has sprouted up with seminars, webinars and training for ICD-10. Those of us who have attended these events and have studied the draft of ICD-10 understand how daunting a task this will be.

Let’s take a look at the steps that need to be taken to transition from ICD-9 to ICD-10. Provider’s offices need to update their billing software, superbills and train their staff in the new specificity that ICD-10 brings. The clearinghouses, for sending electronic claims, have to upgrade their software to handle the new ICD-10 codes. Then the insurance carriers have to upgrade their systems to handle the new codes. This includes determining which of the 68,000 diagnosis codes are payable for each of the 7,800 CPT codes.

All of these steps above are time consuming and costly. Just the loss in productivity and delays in payment for services could devastate a providers practice. Canada, who converted to ICD-10 in 2004 has not risen to their pre-ICD-10 production rates. One seminar that I attended last year on ICD-10 discussed Australia’s conversion to ICD-10 in 1998. The one bit of wisdom that came from that discussion was that every provider should have at least six months worth of operating expense in the bank when the transition to ICD-10 takes effect. In this economy, there are not too many practices that can afford to put that much money aside.

We all understand the need for the United States to convert to ICD-10. We should have done it years ago, but we didn’t. The United States needs to be on the same diagnosis standard as the rest of the world so that data can be correctly compared. Hopefully CMS will take the costs of converting to ICD-10 into account and give our medical community a reprieve until a time when the costs won’t be have such a dramatic effect on our providers.

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