ICD-10: What the new code set means for payers and providers

Hospitals, health systems and physician practices invested a lot of time and money preparing for the switch from the ICD-9 coding set to ICD-10, and after numerous delays by the federal government, the industry officially moved over to the new code set Oct. 1.

Early reports indicate that the transition to the new codes was largely uneventful for some organizations. Aetna, Humana, Anthem and Cigna said last week they were following federal guidelines and are not denying Medicare Part B physician fee schedule claims that lack specificity, as long as they contain an ICD-10 code from the right family of codes. And hospital executives interviewed byFierceHealthIT on Oct. 2 said that except for a few hiccups, the first day was a relative success.

But physician practices have reported the conversion has led to delays in care and difficulty accessing payer sites. Part of the problem is that some physician practices held out hope that there would be another delay. As a result, some organizations didn’t fully prepare or train staff and may experience implementation headaches. After all, the new coding set adds 50,000 additional diagnosis codes and requires more detailed information in order to select the correct code for a symptom, disease or provided service. But in time, all organizations will get used to the change.

“The longer you’ve done something a certain way, the harder it is to accept change. And we’ve been using ICD-9 since 1979. But the process is still the same, just with different codes,” Sue Bowman, senior director of coding policy and compliance at the American Health Information Management Association, tellsFierceHealthcare in an exclusive interview.

In this special report, FierceHealthcare looks at the steps payers and providers must now take to fully transition to the new code set and what the future holds.

Source: http://www.fiercehealthcare.com/