The new normal

4 tools to ease your transition to ICD-10

Ready or not, ICD-10 is here. Ensure a successful conversion to the new code set with these helpful tools and resources.

The countdown is finally over. Effective Oct. 1, practices across the nation were required to begin using the ICD-10 code set, which includes nearly 70,000 diagnosis codes in contrast to ICD-9’s 14,025 codes.

Although the increased number of codes may seem daunting, a wealth of tools and resources are available to help you transition successfully.

  1. Tactical tools: The AOA has developed an ICD-10-CM Transition Workbook to guide your practice through the process of moving from ICD-9 to ICD-10. Wherever you are in your ICD-10 journey, this workbook will provide practical tips and examples of proper medical record documentation. In addition, an ICD-9-10 mapping guide is available in PDF or Excel format.
  2. Guides and webinars: Check out additional ICD-10 resources from the AOA, including FAQs, webinars and info on the practical approach to ICD-10.
  3. Coding support: If you are in need of additional support regarding ICD-10 processing issues, contact the AOA at AOAICD10@osteopathic.org.
  4. CMS resources: CMS recently released a Quick Start Guide to ICD-10 that focuses on quick references and key steps physicians can take to implement the Oct. 1 transition.

Additional Takeaways

CMS also issued several clarifications you should keep in mind:

  • Medicare claims with a date of service on or after Oct. 1, 2015 will be rejected if they do not contain a valid ICD-10 code.
  • A complete list of the 2016 ICD-10 CM valid codes is available on the CMS website.
  • For 12 months after ICD-10 implementation, Medicare contractors will not deny claims billed under Part B based solely on the specificity of the ICD-10 diagnosis codes, as long as a valid code from the right family of codes is used.
  • A “family of codes” includes codes within a category that are clinically related and provide differences in capturing specific information on the type of condition.
  • This one-year period of claims payment review leniency for ICD-10 codes only applies to Medicare fee-for-service claims. Each commercial payer will have to determine whether it will offer similar audit flexibilities.
  • If a claim is rejected, physicians will be informed if it was due to an invalid code. Existing procedures should be followed for correcting and resubmitting rejected claims and issues related to denied claims.

Next month, the AOA will ask members to complete a survey to determine how the ICD-10 transition has impacted members. The survey will be confidential and results will be posted in the ICD-10 section on Osteopathic.org. We look forward to your participation and will use your feedback to create new materials and tools that will help inform your coding process.

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