With the closing in of the ICD-10 implementation date of October 1, 2015, a lot of concerned parties ask, “What is revenue cycle management bound to be in the foreseeable future?”. With all the speculations going on leading to ICD-10’s implementation, authoritative entities like the Centers for Medicare and Medicaid Services (CMS) have set things straight with a few important facts that all healthcare providers must know.
A. Alternate Electronic Claim Submission Opportunities Might Gain Ground
You can avoid being ill-prepared for ICD-10 via alternate assistance. You can choose from available options including free billing software (downloadable from a registered Medicare Administrative Contractor or MAC), Part B claims submission functionality on a MAC’s provider internet portal for half of MAC jurisdictions, and submission of paper claims if provisions of the Administrative Simplification Compliance Act are met.
B. The ICD-10 Shift Is Necessary
The U.S is the only country in the world with modern healthcare that still hasn’t adopted ICD-10, but playing catch-up is only half the story. According to the CMS, the ICD-10 shift is imperative because of several limitations linked to the old code: ICD-9 is extremely inadequate in terms of data on medical conditions and hospital inpatient procedures; it’s terribly outdated at 30 years old; and it’s limiting the number of codes which can be created.
C. ICD-10 Is NOT Impossible To Grasp
While a seamless shift to ICD may not happen overnight, it’s not entirely difficult to implement, either. Several concerned parties have warned that the increased number of codes will make ICD-10 impossible to use. However, the alphabetical Index and electronic coding tools will continue facilitating proper code selection. Using the ICD-10 code sheet directly is recommended, instead of translating ICD-9 codes to ICD-10.
D. ICD-10 Claim Submissions Have Specific Limitations
According to the CMS, healthcare providers who are ill-prepared for ICD-10 will be unable to submit claims for any services rendered on or after October 1. Only claims coded with ICD-10 will be recognized for services rendered on or after the implementation date, and such submissions can be done via electronic means or through the alternate methods described previously.
Some revenue cycle management experts have pointed out that the implementation of ICD-10 may slow down the revenue cycle process, as historically shown in other countries. It is recommended that practices take a good look at their RCM practices now, and find ways to improve their current revenue cycle to offset any negative effects ICD-10 may bring. To this end, practices are encouraged to consult revenue cycle management services and other support services who specialize in improving RCM through eligibility management, like DECO Recovery Management.
ICD-10 Implementation: Five Facts You Need To Know, RevCycleIntelligence.com, April 24, 2015
ICD-10 Implementation: Five More Facts You Need To Know, RevCycleIntelligence.com, May 1, 2015
8 Things You Need To Know About ICD-10, WebPT.com, July 18, 2013
Top 5 Myths And Facts About ICD-10 Implementation, RevenueMasters.com, September 18, 2014