MDS Alert

Published on Fri Jul 24, 2009 PDF

Don't count on much wiggle room on the implementation deadline.

Although confusion about the ICD-10 transition abounds, the Centers for Medicare & Medicaid Services aimed to assuage some concerns during its May 19 CMS Open Door Forum on the topic.

For instance: The implementation date for ICD-10 remains Oct. 1, 2013 but after that date, contractors will accept ICD-9 codes for services with dates prior to Oct. 1, 2013 "for a period of time," noted Pat Brooks, senior technical advisor with CMS, during the call. However, CMS has not revealed how long after the ICD- 10 implementation date it will accept those codes.

What this means: "When the time comes, [providers] will want to submit their claims for dates of services prior to Oct. 1, 2013 as quickly as possible," notes coder Liza Shuman with Health Care Consultants in Boston. "The phrase 'for a period of time' seems to indicate that they will only accept the old ICD-9 codes for a short duration, even for claims submitted for dates of service prior to Oct. 1, 2013."

Mapping resources: CMS provided a quick tour of its ICD-10 mapping system, which is posted on its Web site. The crosswalk, known as "general equivalency mappings" or "GEMs," will help providers convert the existing ICD-9 codes to the new ICD-10 codes, and vice-versa.

Don't Count On PDA Files

One listener asked the CMS officials how big a role their software will play in converting ICD-9 codes to ICD-10. Brooks noted that it's unclear whether software vendors will offer conversion products, but suggested that providers interested in converting large numbers of codes from ICD-9 to ICD-10 could automate the conversion on their own using the CMS GEM User's Guide as a resource. "If you had a smaller project, a list of only 20 or 30 codes you personally wanted to convert, you probably could manually use the GEMs and make that conversion and check that in your books as well," Brooks advised.

Brooks also responded to a question from a caller who wanted GEMs files to function on handheld computers like Palms. CMS hasn't configured its files for portable digital assistant devices, but "it wouldn't surprise me if vendors created additional applications," Brooks noted.

Caution: Don't rely too heavily on CMS' GEMs files, however, Brooks warned.

"These GEMs aren't something that you'd want to carry around and just routinely code from," he said in the call. "You'd want to code from the actual code book itself." But the GEMs files will provide "an additional tool" that providers can use to assist with the conversion, he added.

Note: To access CMS' ICD-10 resources, visit www.cms.hhs.gov/ICD10.