2017 Coding update

Mchilcoat76

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Hi Everyone! I need any input from coders. I am currently in the process to become a coder but have been doing billing for 20 years. My question is this!
I work for a billing company and our software updated to the new 2017 ICD10 codes, so with the new codes comes rejects from our clearing house. When the codes updated we were not notified. Our Team Lead advised us to just change the ICD 10 code in our clearing house to what the old ICD10 was. The problem with this is that our billing system updated so the doctors we bill for chose this. We are not in any way coders. The doctors we are contracted with enter their own coding and we just process the claims and payments. My question is if we change the ICD10 2017 code is that not the same as just changing any type of diagnosis code? I tried to explain that we can't change a diagnosis no matter what, but she would not listen. I will not change a diagnosis because the new 2017 update codes out and we should not be down coding or up coding the ICD10 codes in anyway. Can I get some input from coders on this.Thank you all in advance for any help at all.
 

CodingKing

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I'm a little slow this evening. Are you saying the system is not allowing 2016 ICD codes to be used? So its using codes that exist in 2017 (eff october 1st) but dont exist in 2016? I'm asuming thats what you mean as the new codes are not valid for dates of service prior to 10/1/16.

If that's the case if probably just use the GEMS files from CMS to map back to the 2016 codes. Most of the changes increasd specificity so mapping them back to the NOS, NEC they used to go to shouldnt be an issue.

https://www.cms.gov/Medicare/Coding/ICD10/2017-ICD-10-CM-and-GEMs.html

File name is:

2017 General Equivalence Mappings (GEMs) – Diagnosis Codes [ZIP, 1MB]
 

golymom

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You aren't changing the diagnosis, you are correcting the code to correspond to the documented diagnosis and to match the current official code. The provider is documenting the diagnosis in words. Those words need to match the diagnosis code billed and the code billed must be base upon the current codes. It still can't be a matter of just changing the code. It must be the code that corresponds to the documented diagnosis.
 
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