How to make a successful transition to ICD-10-CM

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Registration for April 2015 ICD-10 end-to-end testing now open

On October 1, 2015, all HIPAA covered entities MUST submit claims using ICD-10 codes. To help prepare for this transition, the Centers for Medicare & Medicaid Services (CMS) is soliciting volunteers to conduct limited end-to-end testing with the MACs during the week of  April 27-May 1, 2015. Fifty participants for each MAC will represent a broad cross-section of provider types, claims types, and submitter types. Those selected will be notified of the specific details regarding the test and who to contact for testing support by January 26, 2015.

To be considered for this testing effort, dermatology practices must complete carrier volunteer forms by January 21, 2015.

HHS sets Oct. 1, 2015 deadline for ICD-10 implementation

The U.S. Department of Health and Human Services (HHS) issued a rule finalizing Oct. 1, 2015 as the new compliance date for healthcare providers, health plans, and health care clearinghouses to transition to ICD-10. The deadline was delayed to allow providers, insurance companies, and other stakeholders additional time to implement ICD-10, which restructures the diagnosis classification system with a significant increase in the number of codes, expanded code lengths, and narrative descriptions, allowing for greater granularity. Dermatology alone is moving from 9,000+ ICD-9 codes to more than 22,000 codes in ICD-10. For additional information about ICD-10, visit http://www.cms.gov/Medicare/Coding/ICD10/index.html.

ICD-10 External Testing Opportunities

United Healthcare - ICD10Questions@uhc.com 
Aetna – contact provider relations to check eligibility
BCBS - contact provider relations to check eligibility
Humana - ICD10inquiries@humana.com





Q: What changes can I expect when using the new ICD-10-CM codes?

A: ICD-10-CM is not just an update of ICD-9-CM codes. It is a restructuring of the diagnosis classification system with a significant increase in the number of codes, expanded code lengths, and narrative descriptions, allowing for greater granularity. Dermatology alone is moving from 9,000+ ICD-9-CM codes to more than 22,000+ codes in ICD-10-CM.

Q: When is the ICD-10-CM compliance deadline?

A: The compliance deadline for ICD-10-CM is Oct. 1, 2015. All Health Insurance Portability and Accountability Act (HIPAA)-covered entities with transactions that have dates of service on or after Oct. 1, 2015 must be submitted using ICD-10-CM.

Q: What does ICD-10-CM compliance mean?

A: ICD-10-CM compliance means that all HIPAA-covered entities must implement ICD-10-CM for use in standard electronic transactions (including but not limited to claims) for health care services provided on or after Oct. 1, 2015.

Q: Who is affected by the transition to ICD-10? If I don’t deal with Medicare claims, will I have to transition?

A: Everyone covered by HIPAA must use ICD-10-CM starting Oct. 1, 2015. This includes health care providers and payers who do not deal with Medicare claims. Organizations that are not covered by HIPAA, but use ICD-9-CM codes should be aware that their coding may become obsolete if they do not transition to ICD-10-CM.

Q: What happens if I don’t switch to ICD-10-CM?

A: If you don’t transition to ICD-10-CM, all your claims for all health care services performed on or after Oct. 1, 2015, will not be processed, therefore risking claim denials.NOTE: Claims for services provided before Oct. 1, 2015, must use ICD-9-CM diagnosis codes.