Improve your ICD-10 coding know-how.
Denials aren't the lone thing you have to dread if your practice doesn't implement ICD-10 by the Oct. 1, 2013 deadline. You could be slapped with fines, too, according to CMS.
Here are some FAQs that will surely help you ramp up your ICD-9 to ICD-10 conversion for your practice.
Get ready for Medicare and Other Payers
CMS has no plan of delaying the implementation of ICD-10 further than the Oct. 1, 2013, date. Though, not all entities are ready for the conversion.
Question 1: Just the entities covered by HIPAA need to make the transition form ICD-9 to ICD-10 -- does that imply that workers' compensation insurers will carry on using ICD-9, even after the remaining industry transitions to ICD-10 on Oct. 1, 2013?
Answer: The answer to that is vague, however CMS has heard murmurs that workers' comp. insurers will shift form ICD-9 to ICD-10.
Question 2: How about Medicaid?
Answer: CMS presented rankings for state Medicaid preparation. Remember that state Medicaid programs are at greater peril for not meeting the ICD-10 implementation date, whereas 21 states are at moderate danger. Fifteen states are at little risk, and four states have informed CMS where they stand in the process.
Question 3: What are the penalties fixed for entities that come under HIPAA who wish not to use ICD-10 codes as of Oct. 1, 2013?
Answer: Your claims will be denied -- and you technically could face fines as use of the ICD-10 codes comes under the HIPAA transaction code set regulations.
Denials: From a practical perspective, as of service dates of Oct. 1, 2013, if you don't use ICD-10 codes, most probably your claims will be returned and will be asked to transition from ICD-9 to ICD-10.
Fines: The penalties are the similar penalties that any HIPAA entity would be subject to. Most of you are acquainted with the ongoing HIPAA transaction codeset penalty that calls for a maximum of $25,000 per covered entity per year, but the HITECH legislation of last year in fact increased those transaction and codeset penalties, and they can be as high as $1.5 million per entity every year.
Carry on With Codesets and Coverage
Your ophthalmology practice can't get ready for the ICD-9 to ICD-10 transition all alone. Study the following questions to see how others' preparations can help or hinder you.
Question 4: The Medicare local coverage decisions (LCDs) presently list the payable ICD-9 codes that agree to all Medicare-payable procedures. Will contractors issue updated LCDs to the public before the Oct. 1, 2013 implementation date to demonstrate the payable ICD-10 codes for the procedures?
Answer: The answer to is unclear. The LCDs will be translated as they will need to be translated, however, as it relates to having them accessible to the public prior to the implementation date, that is not yet sure, as everyone is working fast and furious on all of ICD-10 implementation efforts.
The above ICD-9 to ICD-10 information is brought to you by SuperCoder.com. Log on to www.supercoder.com for more expert Medical Billing and coding guidance, news and information.
Article source :- http://www.supercoder.com/coding-newsletters/my-ophthalmology-coding-alert/icd-10-countdown-get-ready-or-get-fined-thats-the-cms-message-108716-article
Denials aren't the lone thing you have to dread if your practice doesn't implement ICD-10 by the Oct. 1, 2013 deadline. You could be slapped with fines, too, according to CMS.
Here are some FAQs that will surely help you ramp up your ICD-9 to ICD-10 conversion for your practice.
Get ready for Medicare and Other Payers
CMS has no plan of delaying the implementation of ICD-10 further than the Oct. 1, 2013, date. Though, not all entities are ready for the conversion.
Question 1: Just the entities covered by HIPAA need to make the transition form ICD-9 to ICD-10 -- does that imply that workers' compensation insurers will carry on using ICD-9, even after the remaining industry transitions to ICD-10 on Oct. 1, 2013?
Answer: The answer to that is vague, however CMS has heard murmurs that workers' comp. insurers will shift form ICD-9 to ICD-10.
Question 2: How about Medicaid?
Answer: CMS presented rankings for state Medicaid preparation. Remember that state Medicaid programs are at greater peril for not meeting the ICD-10 implementation date, whereas 21 states are at moderate danger. Fifteen states are at little risk, and four states have informed CMS where they stand in the process.
Question 3: What are the penalties fixed for entities that come under HIPAA who wish not to use ICD-10 codes as of Oct. 1, 2013?
Answer: Your claims will be denied -- and you technically could face fines as use of the ICD-10 codes comes under the HIPAA transaction code set regulations.
Denials: From a practical perspective, as of service dates of Oct. 1, 2013, if you don't use ICD-10 codes, most probably your claims will be returned and will be asked to transition from ICD-9 to ICD-10.
Fines: The penalties are the similar penalties that any HIPAA entity would be subject to. Most of you are acquainted with the ongoing HIPAA transaction codeset penalty that calls for a maximum of $25,000 per covered entity per year, but the HITECH legislation of last year in fact increased those transaction and codeset penalties, and they can be as high as $1.5 million per entity every year.
Carry on With Codesets and Coverage
Your ophthalmology practice can't get ready for the ICD-9 to ICD-10 transition all alone. Study the following questions to see how others' preparations can help or hinder you.
Question 4: The Medicare local coverage decisions (LCDs) presently list the payable ICD-9 codes that agree to all Medicare-payable procedures. Will contractors issue updated LCDs to the public before the Oct. 1, 2013 implementation date to demonstrate the payable ICD-10 codes for the procedures?
Answer: The answer to is unclear. The LCDs will be translated as they will need to be translated, however, as it relates to having them accessible to the public prior to the implementation date, that is not yet sure, as everyone is working fast and furious on all of ICD-10 implementation efforts.
The above ICD-9 to ICD-10 information is brought to you by SuperCoder.com. Log on to www.supercoder.com for more expert Medical Billing and coding guidance, news and information.
Article source :- http://www.supercoder.com/coding-newsletters/my-ophthalmology-coding-alert/icd-10-countdown-get-ready-or-get-fined-thats-the-cms-message-108716-article
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