Record numbers anticipated for the annual event

Each year, the American Academy of Professional Coders’ National Conference draws attendees from across the globe. Record numbers are anticipated for the 17th Annual National Conference at The Rio Hotel in Las Vegas April 5-8, 2009. The 2009 National Conference promises to provide coders, physicians and health care professionals with up-to-date and necessary educational courses. Registration for the conference is now open. Read more »

In August, the federal government announced a proposal to update the nation’s healthcare coding system. However, a new study found the plan would significantly increase costs for physician practices. A number of healthcare groups—including the AAPC—have called on the U.S. Department of Health and Human Services to “reassess its plan to rapidly adopt ICD-10 and extend the implementation time frame.”

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The AAFP came out swinging recently against CMS’ proposal for the adoption of the greatly expanded ICD-10 system. AAFP believes that CMS has not done its homework in assessing the impact in the transition. This article looks at the impacts of the proposed rule.

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The Advance Medical Technology Association, American Hospital Association and American Health Information Management Association urged Congress in a letter Tuesday not to delay adoption of the new ICD-10 diagnosis and coding system.

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Findings from a study commissioned by the ICD-10 Coalition, which is made up of 32 health care groups and organizations, are examined. The study found HHS’ plan to implement ICD-10-CM in 2011 would significantly increase costs for physician practices. The ICD-10 Coalition argues that the costs of implementing ICD-10 in a short timeframe will cost more than estimates by the Centers for Medicare & Medicaid Services and could strain the resources of healthcare providers.

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To show the added complexity that providers will face when using ICD-10-CM, the Blue Cross Blue Shield Association converted a superbill from ICD-9-CM to ICD-10-CM.

• View the original ICD-9-CM superbill
• View the ICD-10-CM superbill created using CMS crosswalks

Important things to understand from this exercise:

1. A superbill is a form used by medical practitioners and clinicians so they can quickly complete and submit the procedure(s) and diagnosis(s) for a patient visit for reimbursement. It is generally customized for a provider office and contains patient information, the most common CPT (procedure) and ICD (diagnostic) codes used by that office, and a section for items such as follow-up appointments, copays, and the provider’s signature. Read more »

New Study Finds ICD-10 Mandate Hardship for Health Care Providers
Typical 10-physician practice to spend $285,240 to comply with new federal mandate

(Washington, DC)— A controversial proposed rule from the US Department of Health & Human Services (HHS) requiring all physician practices and other providers to adopt a new coding set – the ICD-10 code set – by 2011 would dramatically increase costs for physician practices and clinical laboratories, according to a new cost study initiated by a broad group of provider organizations and conducted by Nachimson Advisors. Armed with this new information, these groups call on HHS to carefully reassess its plan to rapidly adopt ICD-10 and extend the implementation time frame. The costs associated with implementing ICD-10 in such a short timeframe, are markedly higher than what CMS has estimated and will place a major burden on providers, taking valuable time away from their patients and straining other resources needed to invest in health information technology. Read more »

New ICD-10 study confirms CMS underestimates costs and time required to implement complex new code set

The American Academy of Dermatology, American Academy of Professional Coders, American Association of Neurological Surgeons, American Association of Orthopaedic Surgeons, American Clinical Laboratory Association, American College of Physicians, American Medical Association, American Optometric Association, American Physical Therapy Association, American Society of Anesthesiology, and the Medical Group Management Association retained Nachimson Advisors to assess the cost impact of the proposed ICD-10 rule on providers. Nachimson Advisors estimated the cost impact of an ICD-10 mandate on three different provider practices:

• A typical “small” practice, comprised of three physicians and two impacted administrative staff.

• A typical “medium” practice, comprised of 10 providers, one full-time coder, and six impacted administrative staff.

• A typical “large” practice, comprised of 100 providers, with 64 coding staff comprised of 10 full-time coders and 54 impacted medical records staff. Read more »

HHS Publishes Proposed Changes to HIPAA Transaction and Code Set Standards

On August 22, 2008, the Department of Health and Human Services (HHS) published proposed changes to the HIPAA Transaction and Code Set Rules signaling the intent to eliminate use of ICD-9-CM as the codes for reporting diagnoses and implementation of ICD-10-CM with a proposed compliance date of October 1, 2011. See 73 Fed. Reg. 49796 (Aug. 22, 2008). There are no staggered implementation dates (for example, small vs. large entities) except for Medicaid Pharmacy Subrogation in the proposed ruling.

As best we can interpret, below is a summary of the ruling:

1. ICD-10-CM increases the number of codes from approximately 13,000 ICD-9-CM diagnosis codes to 68,000 ICD-10-CM codes.
2. An approximate 87,000 ICD-10-PCS codes will be required for inpatient procedure coding, up from the 4,000 codes currently used in ICD-9-CM.
3. The ICD-10-CM codes are up to seven characters in an alpha-numeric system and provide significantly increased granularity over ICD-9-CM codes.
4. HHS believes the long-term benefits of ICD-10-CM include:
   - Able to handle new procedures (estimated 1% of all procedures each year are new)
   - Potentially fewer improper and rejected claims
   - Improved disease management
   - Harmonization of disease monitoring worldwide since most of the rest of the world is already using ICD-10-CM codes

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The Department of Health and Human Services (HHS) announced Friday a long-awaited proposed regulation that would replace the ICD-9-CM code sets now used to report health care diagnoses and procedures with greatly expanded ICD-10-CM (diagnosis) and ICD-10-PCS (hospital procedure) code sets, effective Oct. 1, 2011. In a separate proposed regulation, HHS has proposed adopting the updated X12 standard, Version 5010, and the National Council for Prescription Drug Programs standard, Version D.0, for electronic transactions, such as health care claims. Version 5010 is essential to use of the ICD-10 codes. Read more »