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This e-Newsletter offers the most up-to-date and essential news and information about the transition to ICD-10. If you would prefer not to receive these monthly updates, you can change your email preferences in your account.
ICD-10: What Are You Waiting For?
Another new year has started. With ICD-10-CM going "live" next year, now is the time to stop and check on your ICD-10 implementation progress. There has been some speculation lately regarding a delay in implementation of ICD-10, which may be confusing to some offices. Should you delay your plans and wait to begin your provider efforts hoping that we will not have to be prepared on October 1, 2013?
In the January 2009 Federal Register, the Centers for Medicare & Medicaid Services (CMS) stated that none of the alternatives to implementing ICD-10 that were suggested adequately addressed the shortcomings of ICD-9 and that "commenters overwhelmingly supported our proposal to adopt" ICD-10. CMS has recently stated that nothing has changed. The compliance date for ICD-10 is still October 1, 2013 and CMS will be ready on that date to begin accepting claims with ICD-10 codes. The compliance date is federally mandated for conversion.
ICD-10 implementation is not a quick fix. Larger practices may need over a year to implement. Now is the time to assess or reassess and see if you are where you want to be in your ICD-10 implementation timeline. ICD-10 implementation requires resources – time to plan, time to educate, time to execute, time to upgrade systems, etc. Productivity losses, delayed or denied claims, and frustrated staff are a few things that an unprepared office would face. You may be left scrambling: trying to find education and training, trying to get on a vendor's already full schedule, trying to get your provider's documentation ready, trying to get your policies and procedures updated, trying to get everything done in a shortened time frame. Figure out what you need, when you need it, and how you are going to get it lest you risk revenue issues by procrastinating.
IN THE NEWS
2012 ICD-10-CM Codes Now Available
CMS has released the 2012 ICD-10 codes and GEMs files for use. Vendors will have the new code books available at the beginning of March. You can find the new guidelines and codes here.
Patient at 24 weeks and 3/7 days presents today for a check-up. She has gestational diabetes that has been well controlled on insulin. Recently, she began to have more problems with her control. Her blood sugar recordings were reviewed and found to be out of optimal range. She called last week regarding an appointment and I ordered an HbA1C, which is available today and not in an acceptable range. A detailed physical exam was performed. We will adjust her insulin, have her call back tomorrow, and we will see her at the end of the week. She will continue to monitor her glucose and keep her diary. We discussed when her range would be too high, when she should call us immediately, and when she should present to an urgent care or emergency department for immediate care if we were unavailable.
ASSESSMENT: Gestational diabetes, not well-controlled. Increase insulin and follow plan outlined above.
O24.414 Gestational diabetes mellitus in pregnancy, insulin controlled
Z3A.24 24 weeks gestation of pregnancy
Rationale: In ICD-10-CM, codes for diabetes mellitus in pregnancy are broken down by whether the diabetes is gestational or pre-existing. Codes for gestational diabetes (as in the example above) are further broken down by how the diabetes is controlled (diet, insulin, or unspecified). In 2012 new codes were added to state the specific week of gestation of the pregnancy. In this case, the patient is at 24 weeks, so code Z3A.24 was added to the code assignment.
ICD-10 Implementation Strategies
In this section, we share strategies to help your practice successfully implement ICD-10-CM. Please remember to track your progress in your ICD-10 Implementation Tracker on AAPC's website.
Communication is an essential element for ICD-10 implementation. Now is the time to check for possible areas of weakness in communication. Do a spot check to make sure that everyone knows what is currently in place for your organization's implementation and that people are taking advantage of the opportunities offered. You should make sure that the right people are receiving the right message at the right time. All departments and staff have to work together for the common goal of transitioning to ICD-10. Good communication (via face-to-face meetings, audio conferences, emails, intranet, etc.) keeps everyone engaged and vested in the process.
Recently a new white paper was published on providers and coding professionals working together for ICD-10 compliance. Download A New Dynamic in the Relationship Between Clinicians and Coding Professionals.