“There has to be a mindset in every practice that this isn’t going to be a simple transition,” said Dr. Setzen. “It is not that we bill ICD-9 today and ICD-10 tomorrow.”
Explore this issue:December 2011
After the early planning and research to get ready for the change, the hard work will begin in late 2012 and continue into 2013. After the new code set is frozen in October 2012, the actual implementation of computer system changes, coding training and transition to ICD-10 can begin.
In early 2013, practices should be ready to start testing the new systems. It is important to make sure all claims actually get to billers and clearinghouses. Practices must also follow claims until they are successfully adjudicated by the payer to make sure there are no glitches further down the line. There may be one last minor tweaking of the codes just prior to implementation.
Every practice should find out when its clearinghouse will be ready to accept test batches of claims to see how well the systems work together. They should ask all payers the same process questions. These test runs should take place as soon as possible so that there is time to find and correct problems.
All three experts interviewed stressed that practices must get specific answers to these questions in writing. Vendors who are unwilling or unable to do so may not be ready. Practices encountering this problem should consider changing vendors.
“With ICD-10, it is possible for you to do everything right and still not get paid,” said Buckholtz. “What happens upstream is very important to the practice, too.”
Although the experts see no need to panic at this time, they do stress that now is the time for practices to start to gather information on ICD-10. (See “Resources for Getting Your Practice Ready,”)
Denise Buenning, MsM, director of the Administrative Simplification Group (ASG) in CMS’ Office of E-Health Standards and Services, said ICD-10 will go ahead on schedule.
“In the final rule, we extended the proposed compliance date from October 1, 2011 to October 1, 2013 to accommodate industry feedback that [indicated that] more time would be needed for systems and business process transitions to ICD-10, and there is stakeholder support for CMS adhering to that timeline,” she wrote in an e-mail to ENT Today.
“At this time, practices should be settling on a point person and begin early planning,” Tennant said. “Start looking at timelines, talking to vendors about their plans to provide upgrades, find where ICD-9 codes are currently being used so you know where ICD-10 codes will need to go and develop budgets and training schedules. Basically, find out all you can without spending a dime.”