Healthcare Providers Prepare for New ICD-10 Code Sets this Week

ICD-10 LogoHealthcare providers around the country have been preparing for this Thursday, October 1, when the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets.

ICD-10 consists of two parts:

  • ICD-10-CM diagnosis coding, which is for use in all U.S. health care settings.
  • ICD-10-PCS inpatient procedure coding, which is for use in U.S. hospital settings.

ICD-10 will affect diagnosis and inpatient procedure coding for everyone covered by the Health Insurance Portability Accountability Act (HIPAA), not just those who submit Medicare or Medicaid claims:

  • Claims for services provided on or after the compliance date should be submitted with ICD-10 diagnosis codes.
  • Claims for services provided prior to the compliance date should be submitted with ICD-9 diagnosis codes.

The U.S. Centers for Medicare & Medicaid Services (CMS) has created a special website called RoadTo10.org that bills itself as the “one-stop source for all things ICD-10.”

Also, for any provider in the Passport network who has questions about the ICD-10, you can contact Provider Services at (800) 578-0775, or contact your provider relations specialist. To see other “eNews” mailings that get shared with providers, please click here.

 

Passport Offers Program to Providers to Help Them Get Ready for ICD-10 Transition

EYe ON ICDBeginning Oct. 1, 2015, the ICD-9 code sets that are used by healthcare providers to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets. These new ICD-10 codes will affect diagnosis and inpatient procedure coding for everyone covered by the Health Insurance Portability Accountability Act (HIPAA) in both health care and hospital settings.

In order to successfully implement the new ICD-10 submission requirements on Oct. 1, Passport is recommending that all of our providers begin testing now by contacting their vendors to confirm that they have fully functional, compliant products and services in place. To ensure a successful ICD-10 implementation, Passport will schedule a testing window during the month of August, but this window will be limited to providers who sign up before July 1 and receive confirmation. To sign up, providers should complete the online Provider Testing Sign-Up Form. If you have additional questions or concerns, please contact the Passport ICD-10 testing team at ICD10@amerihealthcaritas.com or call your Provider Relations Specialist at (800) 578-0775.

For more information, the Centers for Medicare & Medicaid Services (CMS) has a dedicated Web page with a wealth of tools and information to help prepare for a smooth transition. And CMS’s “Road to 10” online resource can help smaller practices build action plans as well as provide common codes and resources for primary care and specialty physicians.