If you thought ICD-9 will be a thing of the past after 1st October 2015, the answer is no. For a certain period, medical practices will have to use old as well as new code set when filing claims for payment. Coders will have to use ICD-9 code set if they are filing claim with a date of service before 1st October, 2015.
|CMS will not be accepting claims that have ICD-9 as well as ICD-10 codes. Since the use of both code sets in one claim will not be accepted, practices will have to split a claim in some cases.
|As stated in AHIMA’s FAQ on ICD-10, a dual coding system is fraught with difficulties and this system has the potential to undermine the healthcare industry’s data infrastructure.
The dual coding system has been introduced to save small physician practices from potential financial impact after ICD-10 transition in case their billing team isn’t ready or their in-house coders haven’t received adequate training. But when considered from a different perspective, this system might increase the woes of small practices as their coders might get confused juggling between two code sets.
If not handled expertly, this system will not only confuse the claims processing cycle but also impact patient care and handling of vital patient clinical information. It will require costly and complex changes to the provider and clearinghouse systems and also impact the communication of health information between providers, resulting in low quality of care. If the data infrastructure is changed for dual-coding, it might result in payment errors and breakdowns in communication due to inaccurate processing and linking of medical claims across providers.
There is a strong need to streamline processes like denial management and the turnaround time for claims submission in order to sail through the burden of juggling between two code sets. Practices will have to take a look at the claims history to know what type of claims tend to stay open for a longer time period. This will help them identify areas where they need to tighten their billing procedure.
If a practice is prepared to deal with dual coding system with a team of experienced coders, there is nothing like it. However, for practices that are still struggling with ICD-10 transition due to lack of resources and time, outsourcing of billing and coding services can be a foolproof solution.
Growing number of medical practices are outsourcing their ICD-10 transition needs to MBC to sail through dual-coding challenges. A team of experienced and certified ICD-10 coders have been assigned to handle their coding and billing needs, eliminating their worries about financial disruptions post October 2015. From streamlined billing and coding, vigorous AR follow-ups, and effective denial management to compliance with reforms, practices are benefitting from MBC’s comprehensive RCM solutions and reducing their cash flow problems.