The Smart Medical Practice

ICD-10 Testing: Time to Get Real for Medical Billers


prepare for icd 10 codesAs we get close to the end of the year, there are conflicting calls from various groups regarding ICD-10. Last week, the American Medical Association called for a delay, citing costs between $83,000 and $2.7 million per practice to implement.

This week, the American Hospital Association warned that a delay in implementation would increase costs. According to FierceHealthIT, a July letter sent to House and Senate Members from AHA Executive Vice President Rick Pollack and BCBS Association Senior Vice President Alissa Fox said, “Given that considerable effort and investment have already been made, our organizations oppose any action that seeks to introduce further delay in ICD-10 implementation.”

In June, Dr. Farzad Mostashari, national coordinator for healthcare IT told the HIMSS Media ICD-10 Forum in National Harbor, Md. there would be no extension of the deadline. Thus far, CMS is showing no signs the deadline will slip; its November 18 news update was titled “ICD-10: Less Than One Year Out.”

Assuming the rollout will proceed as planned, training and testing will remain a priority for practices of all sizes during the winter and spring. Indeed, the AHA is called for CMS to expedite its testing plans in a November 20 letter to the agency. It wants testing that’s available to all hospitals to begin no later than January.

“Extensive, end-to-end testing by Medicare contractors and state Medicaid agencies of both the electronic transaction and the adjudication of the claim will be needed to ensure a smooth transition from ICD-9 to ICD-10. Testing is not only essential to ensuring that the transition to ICD-10 goes as smoothly as possible, it is a legal requirement under Section 1104 of the Patient Protection and Affordable Care Act (ACA),” writes Linda Fishman, AHS’s senior vice president of public policy analysis and development.

Practices along with the support of medical billers should follow suit as quickly as possible, especially given that a June study from the Medical Group Management Association found that only 4.8% of the 1,200 medical groups survey said they had made significant progress in their ICD-10 efforts.

“A successful transition to ICD-10 requires coordination between providers and their vendor, clearinghouse and health plan trading partners,” said MGMA President Dr. Susan Turney in a statement. “Our data suggests that many practices are in the dark in terms of moving forward with ICD-10 as this coordination has not yet occurred.”

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