The Centers for Medicare and Medicaid Services Oct. 1 deadline for switching to the International Classification of Diseases 10th Revision (ICD-10) has arrived, and CMS says it is ready to accept ICD-10 claims.
The ICD-10 transfer represents a massive expansion in the codes used to classify disease states. The new revision moves from ICD-9’s 3,824 procedure codes and 14,025 diagnosis codes to a considerably more detailed 71,924 procedure codes and 69,823 diagnosis codes.
Since the World Health Organization completed work on ICD-10 in 1992, 110 nations have been using the unmodified the system, and 25 countries are using a modified version of ICD-10. Now, after literally years of delaying its implementation date, CMS is requiring healthcare businesses filing claims with Medicare to adhere to the new coding system.
That said, in HME Business online polls conducted over the past year, providers replied that despite the deadline pushbacks, they were still not ready. A July survey asked our online readers how their ICD-10 preparations were going in anticipation of the Oct. 1 deadline. Of the respondents, only 18 percent said they were compliant; 36 percent stated they would be complaint by Oct. 1; 27 percent responded they hadn’t started working on it; and 18 percent literally replied they didn’t even know what ICD-10 was. Whether or not they — and providers across the healthcare spectrum — were able to comply by the deadline remains to be seen.
“You may wonder when we’ll know how the transition is going,” Sean Cavanaugh, deputy administrator and director of the Center for Medicare, stated. “It will take a couple of weeks before we have the full picture of ICD-10 implementation because very few health care providers file claims on the same day a medical service is given. Most providers batch their claims and submit them every few days.
“Even after submission, Medicare claims take several days to be processed, and Medicare – by law – must wait two weeks before issuing payment,” he added. “Medicaid claims can take up to 30 days to be submitted and processed by states. Because of these timeframes, we expect to know more about the transition to ICD-10 after completion of a full billing cycle.”
To keep tabs on the transition, CMS says it will be:
- Monitoring the transition in real time.
- Watching its systems.
- Addressing any issues that come to the ICD-10 Coordination Center, a group of Medicare, Medicaid, billing, coding, and information technology systems experts who can call on the entire CMS staff in order to address any issues.
For providers that still need help Cavanaugh suggested these resources:
- The Road to 10 webpage for general ICD-10 information.
- The Medicare Administrative Contractor for claims questions.
- The ICD-10 Coordination Center.
- The ICD-10 Ombudsman, Dr. Bill Rogers, who can act as an impartial advocate.