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Be Ready for ICD-10-CM

Claims submitted for dates of service or inpatient discharges on or after October 1, 2015 must be submitted using ICD-10 codes.  Problems will result from:

  1. Lack of preparation by your billing, practice management, and EHR vendor

  2. Lack of preparation by your payers

  3. Insufficient staff training

  4. Potentially reduced physician and staff productivity

  5. Potential financial risk associated with transition costs

Answer the following questions to know if you are prepared for the transition:

  1. Is your clearinghouse or software vendor ready for the ICD-10 switch?

  2. Have you completed clearinghouse or software vendor tests to insure readiness to accept ICD-10 billings?

  3. Are insurance companies to whom you bill ready to accept and process claims?

  4. If you do your own coding, are you ready for the switch?

  5. Is your staff prepared?

  6. Are you prepared to handle staff questions and inefficiencies?

  7. Is your documentation ready for the level of detail required to determine the appropriate ICD-10 code?

  8. Have you reviewed all billing and documentation reports that rely on data using ICD codes?

  9. Are you prepared for potential revenue disruptions?

  10. Do prior authorizations and standing orders have the correct codes assigned to them for dates of service from October 1, 2015 forward?

  11. Providers billing for Medicare services may conduct acceptance testing with CMS up to September 30, 2015.  Check this link.

  12. If your clearinghouse or billing entity is not ready, CMS offers free billing software to Medicare providers through your MAC.

This link provides a good resource for information about the IT transition to ICD-10.