Wiki Payers exempt from Oct 1, 2014 deadline?

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bridgettemartin

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Our PM system held their vendor-specific ICD-10 update yesterday. In it, I understood the speaker to state that Blue Cross has already told them they will not be ready for the conversion by October 1, 2014. Our PM system will have a way to convert I-10 to I-9 for the payers that have not yet converted by that date.
I already knew that non-HIPPA covered entities were never required to convert, but I didn't realize that commercial payers, although required to convert, aren't being held to the same deadlines as we are. Does anyone know if that is really the case?
 
Penalty for not converting to ICD-10

I was in a conference with my clearinghouse recently and was told that there most likely will be some payers that are required to convert that are not going to convert by the deadline. As incentive to be ready next October there are financial penalties. My guess is the penalties will either expedite those payers in being ready as soon as possible after the deadline or they will use their time wisely between now and then to avoid the penalties. I did not get into who will impose the penalties (CMS), how (recoup/holdback), etc. - just that there would be financial penalties.

Hunter Smith, CPC
 
But what happens to our claims if the insurance carrier isn't ready and we send them a claim with ICD-10 codes? Will they be able to process our claim? Just a thought
 
Hi:

Our billing software has planned for this scenario. We will be able to bill out either ICD-9 or ICD-10 depending on the payer's readiness. I would definitely reach out to your billing software vendors to see what their plan is for this.
 
It is non compliant to use an ICD-9 code for a visit date of Oct 1 and forward. This is a HIPAA regulation. Your failure to comply is a violation subject to fines and penalties. The payers must be ready as they are required to be ready. The people you are speaking to maybe confusing work comp with everyone else. Work comp does not have to comply since they are not a HIPAA entity.
There are numerous transmittals stating that you cannot use an ICD-9code after the Oct 1 visit date.
 
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