Home Health ICD-9/ICD-10 Alert

Published on Fri Jan 20, 2012 PDF

Plus: Medicaid contractors are working to meet ICD-10 deadline.

The Centers for Medicare & Medicaid Services continues to move ahead with plans for the coming ICD-10 transition, which means you'll need to be ready to use the new code set by Oct. 1, 2013 -- less than two years away. Fortunately, home health agencies aren't the only ones working hard to meet the deadline. Contractors, vendors, and individual states are steadily readying their systems for ICD-10 claims processing.

Medicaid: Because Medicaid rules and policies vary on a state-by-state basis, some providers may be expecting states to be on different pages when it comes to ICD-10 implementation. But that would be an inaccurate assumption, CMS reps said during a Nov. 17, 2011 "ICD-10 Implementation" call.

"I can tell you that most states are still conducting impact analyses and gathering business requirements for the things needed to accommodate the implementation of ICD-10," said CMS's Elizabeth Reed during the call. "CMS currently conducts bi-weekly calls with the states and is currently offering state-specific technical assistance training. I would encourage providers to get on their respective state list serves to stay in tune with state communications and testing requirements," she added.

Procedure coding: Fortunately, home health coders won't have to worry about using the procedural codes, known as ICD-10-PCS, because this code set will only be used for inpatient hospital claims, said CMS's Pat Brooks during the call.

Coverage decisions: One caller to the forum asked whether CMS is working on converting diagnosis codes on the national coverage decisions (NCDs), which are currently listed in ICD-9 format, to ICD-10 codes. Brooks assured the caller that CMS reps are working on such a conversion, but no updates exist on how far along the conversion is at this point.

ICD-10: The American Medical Association has taken a stand against the new diagnosis coding system, said Peter A. Hollmann, MD, chair of the CPT Editorial Panel, during the CPT 2012 Annual Symposium in Chicago on Nov. 16, 2011. "There's a lot of anxiety and a lot of stress" about ICD-10, he said, which led the AMA's House of Delegates to formally request a repeal to ICD-10 during the group's Nov. 15 meeting.

Keep in mind: This does not mean that ICD-10 won't go into effect, but it does mean that the AMA is trying to find a workaround to avoid the resources that each practice will have to put into the ICD-10 migration. A formal ICD-10 repeal could only take place following governmental intervention.

The final Word: During the Nov. 17 call, CMS's Denise Buenning responded to a question about whether ICD-10 will actually be delayed or eliminated. "There is no truth to the rumor, there is no pushback -- the date for ICD-10 remains Oct. 1, 2013," she said.