ICD-10 is fast approaching – Are you ready?

July 31, 2015

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The October 1, 2015, ICD-10 compliance date is only two months away. Now is the time to make sure your office is ICD-10 ready. The transition will go much more smoothly for organizations that plan ahead. A successful transition to ICD-10 will be vital to transforming our nation's health care system and ensuring uninterrupted operations.

As previously communicated, for referrals, authorizations, or claims with a date of service on or after October 1, 2015, Independence will only accept ICD-10 codes. We will not accept ICD-9 codes on claims with a date of service on or after October 1, 2015.

Understanding claims that span the compliance date

Depending on the type of claim, there are different rules for how to code a claim with dates of service that span the ICD-10 compliance date. Please refer to MLN Matters® Number: SE1408, a news flash published by the Centers for Medicare & Medicaid Services (CMS) with detailed information based on facility type/service.

Facility/Institutional inpatient claims

Facility/Institutional inpatient claims with a date of discharge on or before September 30, 2015, must be billed with ICD-9 codes. Facility/Institutional inpatient claims with a date of discharge on or after October 1, 2015, must be billed with ICD-10 codes. Do not split inpatient claims by date of service, and do not include both ICD-9 and ICD-10 codes on a single claim.

Professional and outpatient claims

Professional and outpatient claims with a date of service on or before September 30, 2015, must be billed using ICD-9 codes. Professional and outpatient claims with a date of service on or after October 1, 2015, must be billed using ICD-10 codes. We will not accept claims containing both ICD-9 and ICD-10 codes ? as is consistent with CMS billing guidelines.

Billing tip

When claims span the compliance date:

  • Use the date of discharge for facility/institutional inpatient claims.
  • Use the date of service for professional and oupatient claims.

Independence is ready for ICD-10

Independence has conducted thorough testing of our system both internally and externally. Our testing efforts focused on minimizing potential business disruptions for our providers, aligning medical policies to ensure no changes in current policy-based outcomes, and verifying that services covered under ICD-9 will be covered under ICD-10.

Independence is confident with the outcome of our testing results so far, which show that both internal and external validation has been successful. We continue to encourage our providers to take time to train coders and concentrate on clean coding practices to make the transition to ICD-10 as successful as possible.

ICD-10 resources

Independence maintains a dedicated ICD-10 web page where you can find up-to-date information, including updated frequently asked questions and dial-in information for the monthly What's Up Wednesday teleconference series.

The CMS ICD-10 web page offers numerous resources, including the following:

  • Latest News
  • Road to 10 (an online resource built for small practices)
  • CMS ICD-10 Quick Start Guide
We encourage you to use these resources as you prepare for the upcoming compliance date.

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