Dear Valued Provider and Office Staff:
The mandated transition to ICD-10 represents one of the biggest challenges in
health care history, as the change
is far-reaching and affects a number of entities in the health care industry.
Increasing the number of codes
from approximately 24,000 ICD-9 codes to over 140,000 new ICD-10 codes will not
be an easy task and will
require significant upgrades to systems and processes for payers and providers.
Therefore, it is important that
preparation begin now to comply with the mandated ICD-10 implementation date of
October 1, 2013.
Beyond the ability to diagnose diseases on a more granular level, increasing
the number of diagnosis codes
has many additional benefits for providers, including reducing payment errors,
speeding up the reimbursement
process throughout the industry, and the possibility of enhancing quality
measurement and research to inform
changes in health care.
A number of negative scenarios could potentially affect the workflow of
providers who are not prepared to
implement ICD-10 codes by October 1, 2013. Examples include:
rejection of claims payments;
coding and billing backlogs;
inaccurate/incomplete clinical metrics and pay-for-performance reporting that
does not meet peer standards.
Providers can prepare for the transition and avoid being negatively affected by
taking inventory of changes
required at their practice, such as evaluating business and IT efforts that are
involved (e.g., required upgrades
to practice management software). The Centers for Medicare & Medicaid Services
(CMS) has established
recommended timelines for small and large provider offices to comply with the
ICD-10 implementation date of
October 1, 2013. Visit
www.cms.gov/ICD10/03_ICD-10andVersion5010ComplianceTimelines.asp to review these
CMS timelines. Providers are encouraged to use these timelines to gauge their
IBC is committed to sharing information with providers about the mandatory
transition to the ICD-10 code sets.
As part of that effort, we will continue to publish articles in upcoming
editions of Partners in Health UpdateSM that
focus on various transition-related requirements and our plans to comply with
the mandated transition. Providers
can also find information about the ICD-10 transition by visiting
www.ibx.com/icd10. If you have any questions
about our transition to ICD-10, please email them to ICD10@ibx.com.
Thank you for your participation in our network and your efforts to prepare for
Ronald J. Brooks, M.D. Steven J. Brown, M.D. Dale M. Mandel,
Senior Medical Director Medical Director Medical Director