Home Health ICD-9/ICD-10 Alert

Published on Thu Sep 24, 2009 PDF

Hint: This year's biggest change is process-related.

Each year, the Centers for Medicare & Medicaid Services (CMS) announces changes to the ICD-9 code set. Make sure you know why and how to get ready with this handy list.

It's necessary to update ICD-9 each year to track diseases and injuries, especially as new conditions develop, says Judy Adams, RN, BSN, HCS-D, COS-C, president and CEO of Adams Home Care Consulting in Chapel Hill, N.C.

As things change in healthcare, we also need to remove outdated information and terminology and make documentation standard and current, Adams says. The annual ICD-9 changes also allow us to gather more accurate data, facilitate research on diseases and complications, and fix past mistakes, Adams.

The trickiest change this year doesn't have anything to do with a new code but is instead a process issue, says Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, consultant and principle of Selman-Holman & Associates in Denton, Texas.

The change: In past years, the effective date of the code set was based on the "from" date on the plan of care (the first date of the certification period). But this year it's based on the date in MO090 (the date the assessment was completed).

So what if you have a new patient or a recertification start just before Oct. 1, but a new code best describes his condition? Use the 2010 codes only when the M0090 date is Oct. 1 or later, Adams stresses. For anything prior, you must use the 2009 codes, according to CMS verbal direction.

Good news: CMS will accept either the 2009 or 2010 codes for claims spanning Oct. 1, Selman-Holman says. Watch for a release from your intermediary to update you on this process.

Be Prepared for Oct. 1

To make sure you're ready for this year's ICD-9 changes, Adams recommends following these steps:

1. Order your 2010 coding manual. This is the single most important thing you can do to prepare, Adams says.

2. Update cheat sheets and destroy the old ones.

Remember, it's better not to use cheat sheets at all, but if you must, make sure they are accurate.

3. Contact your information systems vendor to determine when the updates of the new codes will be ready to install.

4. Create a list of patients whose cases will require code changes and when they are due.