ICD-10 Code Set Disagreements

MGMA Targets Implementation Date

Staff Reporters

The Medical Group Management Association [MGMA], who previously has published commentary and material from our Executive-Post Editor-in-Chief, Dr. David Edward Marcinko, believes that the Centers for Medicare & Medicaid Services’ [CMS] proposed Oct. 1, 2011 compliance date for full implementation of the International Classification of Diseases, Tenth Revision (ICD-10) code sets is not workable.

Numerous Challenges

According to an August 19th edict, the MGMA said the government must overcome numerous challenges before the health care industry can fully implement ICD-10. The proposed rule for the next generation of the Health Insurance Portability and Accountability Act (HIPAA) electronic transactions (ANSI X12 version 5010), released with the ICD-10 proposed rule, must be put in place prior to ICD-10 and MGMA believes this will take several years for full implementation and testing.

Assessment

Because ICD-10 contains 10 times the number of codes as ICD-9, the newer code set will require vast changes for medical groups, hospitals and other health care facilities. MGMA surveys found that 95 percent of medical practices would have to purchase software upgrades for their practice management systems or buy all new software, while 64 percent concluded that they would have to purchase code-selection software, and 84 percent stated that they did not think public and private health plans would be ready to accept claims with ICD-10 codes by October 2011.

Conclusion

Your thoughts are appreciated. Will you be ready for ICD-10; please opine and comment.


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5 Responses

  1. Hi,

    I read your article regarding transitioning to ICD 10, which said:

    “95 percent of medical practices would have to purchase software upgrades for their practice management systems or buy all new software, while 64 percent concluded that they would have to purchase code-selection software, and 84 percent stated that they did not think public and private health plans would be ready to accept claims with ICD-10 codes by October 2011.”

    I just want to know if readers think all/most medical providers in the US will want to buy a completely new system; or will they just change their database in an existing system only?

    Thanks for all thoughts and comments,

    Rupali

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  2. Rupali – Think ICD-11

    In-as-much as most medical practitioners probably won’t be ready for ICD-10 by October 1, 2013, why not concentrate on the ICD-11 beta version, when available in 2011, and then launching in 2014?

    Michael

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  3. CMS to Offer Tips on ICD-10 Prep

    The CMS will offer “Preparing for ICD-10 Implementation in 2011,” a free teleconference from 1-3 p.m. ET on Jan. 12th. Register online at eventsvc.com through 1 p.m. Jan. 11th. The ICD-10 system increases the number of diagnostic codes to 68,000 from 13,000 and takes effect Oct. 1st, 2013.

    With a target audience that includes medical coders, physician office staff, health-records staff, vendors, educators, system maintenance advisers and all Medicare fee-for-service providers, the teleconference will offer advice on education and training strategies, determining vendor readiness and developing an ICD-10 budget. Information on differences between ICD-9 and ICD-10 and tools for converting codes also will be provided.

    Source: Andis Robeznieks, Health IT Strategist [1/6/11]

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  4. How HIPAA 5010 has fared thus far

    Despite delays, and billing glitches, progress is being made on the conversion. And, there are benefits to the HIPAA 5010 mandate that healthcare entities will reap once they comply.

    http://www.govhealthit.com/news/commentary-how-hipaa-5010-has-fared?topic=30,29

    Jayne

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  5. CMS to Version 5010 Laggards – Get Ready to Borrow Money

    Physicians not yet up to speed on new federal standards for electronic claims should be prepared to borrow money to keep their practices afloat come July. That dire counsel comes from the Centers for Medicare and Medicaid Services (CMS).

    Last week, as it has before, CMS advised physicians who are still trying to comply with the new standards to either take out a line of credit or expand an existing one at a bank because of payment delays that may occur when the agency begins to enforce the standards on July 1st. At stake is the ability of physicians to meet payroll and write rent checks.

    The new standards are called Health Insurance Portability and Accountability Act Version 5010 standards. The successor to Version 4010 standards, they are designed to streamline electronic claims and other digital transactions between providers and third-party payers, including Medicare. Physicians, insurers, makers of billing software, and claims clearinghouses are all under the gun to convert their systems to the new standards.

    Source: Robert Lowes, Medscape News [5/22/12]

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