On August 1, 2014, the Centers for Medicare and Medicaid Services (CMS) provided additional information regarding the upcoming change to the ICD-10 coding system which we regularly use in preparing documents, such as notices to COB&R and Releases, for our clients. If you have wondered why the change is being made, the current ICD-9 coding system has about one-tenth the number of diagnostic and procedures codes as does the ICD-10. Transition to the new system is expected to provide significantly improved specificity as to diagnoses and procedures. We hope, in our role as Medicare Secondary Payer consultants and case managers, that this increased specificity will reduce the number of “unrelated” charges and procedures we see included on interim conditional payment summaries and final demand conditional payment summaries, thus reducing the time and expense our clients face in order to correct erroneous summaries and demands.
CMS has provided the following additional information:
Deadline for ICD-10 Allows Health Care Industry Ample Time to Prepare for Change
Deadline set for October 1, 2015
On July 31, HHS issued a rule finalizing October 1, 2015 as the new compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10. This deadline allows providers, insurance companies, and others in the health care industry time to ramp up their operations to ensure their systems and business processes are ready to go on October 1, 2015.
The ICD-10 codes on a claim are used to classify diagnoses and procedures on claims submitted to Medicare and private insurance payers. By enabling more detailed patient history coding, ICD-10 can help to better coordinate a patient’s care across providers and over time. ICD-10 improves quality measurement and reporting, facilitates the detection and prevention of fraud, waste, and abuse, and leads to greater accuracy of reimbursement for medical services. The code set’s granularity will improve data capture and analytics of public health surveillance and reporting, national quality reporting, research and data analysis, and provide detailed data to enhance health care delivery. Health care providers and specialty groups in the United States provided extensive input into the development of ICD-10, which includes more detailed codes for the conditions they treat and reflects advances in medicine and medical technology.
