[Regina]

So, I realize that I should know more about this, but how will this whole ICD10 thing affect us?

[AndreaStark]

The CDCs' ICD-10-CM coding system is going to replace the current ICD-9 CM system on October 1, 2013. Once the transition takes place, claims submitted with ICD-9-CM diagnosis codes will be denied.

There are approximately 75,000 more ICD-10-CM codes than exist with the current ICD-9-CM set, according to HHS, and not all ICD-9 codes have a corresponding ICD-10. Also, because ICD-10 codes are more specific than ICD-9, one ICD-9-CM may have multiple corresponding ICD-10-CMs.

To read more about the transition to ICD-10-CM codes or to download a copy of CMS’ ICD-9-CM to ICD-10-CM 2009 GEM, visit: http://www.cms.hhs.gov/ICD10/downloads/Dxgem_2009.zip. (Hint: read the DXgem_guide_2009.pdf file first.)


Also, along with the ICD-10 transition there is the HIPAA Version 5010 transition, which has an earlier implementation deadline of January 1, 2012. This transition is being implemented to prepare for the new ICD-10 codes and will affect systems used to submit claims, receive remittances, and exchange claim status or eligibility inquiries. So you should talk with your clearinghouses, billing agents and software vendors to ensure they are preparing to meet the new version’s standards.


All claims must be submitted using the new 5010 standards effective January 1, 2012. After this date, no claims will be accepted using the old electronic 4010/4010A1 versions, regardless of the claim’s date of service.

CMS has created a website to help educate providers on the transition. That website is: http://www.cms.hhs.gov/Versions5010andD0/.


I work for DME consultant Andrea Stark and she will be providing further updates on these transitions in her next issue of Vista Notes (a bi-monthly news publication Andrea releases for DMEPOS suppliers). If you aren't already a subscriber I'd be happy to get you signed up or you can visit: http://www.miravistallc.com/products.php.

Sincerely,

Michelle Hamel
Communications Specialist
MiraVista, LLC