There are a lot of issues that are of concern for healthcare professionals, providers and players in the healthcare business regarding the ICD-10 transition deadline. There are some common myths which we discussed and dispelled last week, these were myths that stakeholders had about the ICD-10 transition deadline. This week we will discuss five more factors that will give an insight to some of the concerns and questions about ICD-10 implementation.

  1. Medicare offers options for those who can’t submit electronically

The system has issues that limit some providers to submit claims electronically with the ICD-10 diagnosis codes. Though Centers for Medicare & Medic aid Services (CMS) pushes stakeholders and providers to submit their ICD-10 claims electronically before October 1st, 2015, however, there are additional options that entities can proceed with. One of the best examples is the ability to download the free billing software at any point and anywhere from one’s Medicare Administrative Contractor (MAC).

Furthermore, about 50 percent of Medicare Administrative Contractors offer Part B claims submission functionality through an Internet portal. It is also possible to submit papers if your Administrative Simplification Compliance Act waiver passes through. Whether one chooses the internet portal or the free billing software, make sure that the stuff gets sufficient training on both platforms before the deadline of the ICD-10 transition.

  1. Only claims using the new coding system will be accepted after the ICD-10 transition deadline

You will not be in a position to submit any claims for services performed on or after October 1st, 2015 in case your medical practice is not ready to submit ICD-10 claims. After the ICD-10 deadline, the Centers for Medicare & Medicaid Services will only accept claims using the new diagnostic codes.

  1. ICD-10 codes do not decide reimbursement for physician office and outpatient procedures

HCPCS and CPT procedure codes are mainly used to pay doctors for their physician and outpatient office procedures. The codes are not scheduled to change; in addition, the new ICD-10 diagnostic codes will under no circumstance interfere with this type of reimbursement.

On the other hand, during inpatient hospital procedures, ICD-10-PCS codes will directly affect in almost the same way that ICD-9 codes are presently used. Furthermore, ICD-10 codes are sometimes used to make decisions on medical necessities irrespective of the healthcare setting.

  1. The costs of upgrading to the new coding system by the ICD-10 transition deadline are much lower than expected

Most of the EHR vendors are including the upgrade to the new ICD-10 codes in their systems at very low costs to their customers, this is according to studies that were done and published by the Professional Association of Health Care Office Management and other studies also published in the Journal of AHIMA. This translates to minimal costs of systems and software upgrades in planning for the ICD-10 transition deadline.

  1. The time has come to move to the ICD-10 coding set

The ICD-10 coding set plays a significant role in enhancing the quality of care and updating the medical space provided across the healthcare spectrum. This upgrade will help to improve the coordination of patients care, emergency response, fraud detection strategies, payment models, public health studies, research and surveillance. It is a significant transition to move forward to the new coding set.


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