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Five More Facts about ICD-10 from CMS

are you allergic to anything cartoonThe other week, the Centers for Medicare & Medicaid Services (CMS) shared five facts dispelling misperceptions about the transition to ICD-10.  We posted about that and added some comments.  In case you missed it, you can read that one here.

Here are five more facts addressing common questions and concerns CMS has heard about ICD-10:

Five More Facts about ICD-10 & comments about them

1. If you cannot submit ICD-10 claims electronically, Medicare offers several options.

CMS encourages you to prepare for the transition and be ready to submit ICD-10 claims electronically for all services provided on or after October 1, 2015. But if you are not ready, Medicare has several options for providers who are unable to submit claims with ICD-10 diagnosis codes due to problems with the provider’s system. Each of these requires that the provider be able to code in ICD-10:

  • Free billing software that can be downloaded at any time from every Medicare Administrative Contractor (MAC)
  • In about ½ of the MAC jurisdictions, Part B claims submission functionality on the MAC’s provider internet portal
  • Submitting paper claims, if the Administrative Simplification Compliance Act waiver provisions are met

If you take this route, be sure to allot time for you or your staff to prepare and complete training on free billing software or portals before the compliance date.

2. Practices that do not prepare for ICD-10 will not be able to submit claims for services performed on or after October 1, 2015.

Unless your practice is able to submit ICD-10 claims, whether using the alternate methods described above or electronically, your claims will not be accepted. Only claims coded with ICD-10 can be accepted for services provided on or after October 1, 2015.

3. Reimbursement for outpatient and physician office procedures will not be determined by ICD-10 codes.

Outpatient and physician office claims are not paid based on ICD-10 diagnosis codes but on CPT and HCPCS procedure codes, which are not changing. However, ICD-10-PCS codes will be used for hospital inpatient procedures, just as ICD-9 codes are used for such procedures today. Also, ICD diagnosis codes are sometimes used to determine medical necessity, regardless of care setting.

4. Costs could be substantially lower than projected earlier.

Recent studies by 3M and the Professional Association of Health Care Office Management have found many EHR vendors are including ICD-10 in their systems or upgrades—at little or no cost to their customers. As a result, software and systems costs for ICD-10 could be minimal for many providers.

5. It’s time to transition to ICD-10.

ICD-10 is foundational to modernizing health care and improving quality. ICD-10 serves as a building block that allows for greater specificity and standardized data that can:

  • Improve coordination of a patient’s care across providers over time
  • Advance public health research, public health surveillance, and emergency response through detection of disease outbreaks and adverse drug events
  • Support innovative payment models that drive quality of care
  • Enhance fraud detection efforts

What this means for smaller independent practices (from our perspective)

First – Don’t put yourself in a position where you are scrambling to try and figure out a work-around at the 11th hour.

It is very nice that Medicare offers some options for you in the event that you haven’t gotten your act together in time.  The problem with this is that you will still be scrambling to figure things out, to learn a new system, to learn what crazy hoops you have to jump through just to get by.  This will still cripple your operation.

Don’t rely on some duct tape patch job free software program provided by MAC.  The software may be free but your time is not.  Remember this is free software for sending a claim – period.  It is not a Practice Management software and it will not integrate with Medisoft or Lytec.

In the free program, you won’t be able to post payments, send statements, run reports, track aging, etc.  This means you will still need to log all of the information into your Practice Management software (Medisoft or Lytec), and then rekey it into the “free software” so that you can submit the claim.

If you are already using Medisoft or using Lytec for your billing, your best bet is to continue managing all aspects of your billing from one place in a program that you are already familiar with.

We also recommend getting the ICD-10 ready version early.  Get it early so you can practice and be prepared.  Get it early so you don’t get caught in a tidal wave of other practices who are waiting till the last minute.

 

Second – if you are using the Medisoft or Lytec EMR systems, the ICD-10 billing components are included.

When you use McKesson Practice Choice EMR that is integrated with either Lytec or Medisoft, your ICD-10 ready version of Lytec or Medisoft is included with the EMR subscription.  Same with Lytec MD or Medisoft Clinical EMR systems.  If you have already been using these systems then the ICD-10 features you need are already available to you.

If you are one of the hold-outs for implementing EMR, and if you have not upgraded your PM software, then maybe now is the time to consider implementing an EMR.  Aside from all the regular advantages of implementing EHR (which are many), and also aside from the fact that when you implement a Medisoft or Lytec EHR you will get the ICD-10 features for free, there are many aspects of our EHR systems that will make your life easier with the transition to ICD-10.

Do you want to learn how to make the transition to ICD-10 easier on you?

Click here to opt-in to our ICD-10 webinar recordings.

 

Start Practicing Using Your ICD-10 Codes As Soon As…Now!

Even if you have all of the tools that you need, if you wait until October 1 to start using everything, then it will be a rough transition.  If you haven’t worked out your own kinks, then you could see significant delays in getting your claims paid and you will be frustrated with the process.  Don’t do that to yourself.  You can start practicing today!

Here are a couple tips to help you start practicing.

Our second webinar recording shows you how to put your software (either Lytec or Medisoft) into “testing mode” so that you can submit test claims.  In our third webinar, we outline how you can test your ICD-10 claims with your clearinghouse.  We provide specific information from Relay Health because that is our preferred clearinghouse, but we give you the info you need so you can enquire with your own.

There is also a feature in your ICD-10 version of the program that allows you to just start coding everything in ICD-10 right now, but your claims will still be submitted in ICD-9 right up until September 30th!  In the program, you can set a date for when to start submitting your ICD-10 claims.  Set that date right now so you don’t need to worry about making any changes on the morning of October 1.  Learn how to do this by watching the webinars.

Doing all this will allow you to practice coding in ICD-10 now and so that you and your staff can get comfortable with the changes, but without the added stress of potentially delayed payments.

Good luck!  Please comment below if you have any questions, need any help, or have any success / failure stories to share with the community.

 

Disclaimer: AZCOMP Technologies, Inc, (AZCOMP) is providing this material as an informational reference for practices who currently submit claims using ICD-9 codes. Although every reasonable effort has been made to assure the accuracy of the information within these pages at the time of posting, the Health Care industry is constantly changing, and it is the responsibility of each provider to keep themselves up to date of industry requirements.

Five Facts about ICD-10 from CMS

quick fix icd-10 conversion team cartoon

The Centers for Medicare & Medicaid Services (CMS) recently talked with providers to identify common misperceptions about the transition to ICD-10 in order to help dispel some of the myths surrounding ICD-10.  Some of the most common questions and concerns about ICD-10 are covered in these five facts written by CMS.

The Five Facts about ICD-10 & CMS comments about them

1. The ICD-10 transition date is October 1, 2015.

The government, payers, and large providers alike have made a substantial investment in ICD-10.  This cost will rise if the transition is delayed, and further ICD-10 delays will lead to an unnecessary rise in health care costs.  Get ready now for ICD-10.

2. You don’t have to use 68,000 codes.

Your practice does not use all 13,000 diagnosis codes available in ICD-9.  Nor will it be required to use the 68,000 codes that ICD-10 offers.  As you do now, your practice will use a very small subset of the codes.

3. You will use a similar process to look up ICD-10 codes that you use with ICD-9.

Increasing the number of diagnosis codes does not necessarily make ICD-10 harder to use.  As with ICD-9, an alphabetic index and electronic tools are available to help you with code selection.

4. Outpatient and office procedure codes aren’t changing.

The transition to ICD-10 for diagnosis coding and inpatient procedure coding does not affect the use of CPT for outpatient and office coding.  Your practice will continue to use CPT.

5. All Medicare fee-for-service providers have the opportunity to conduct testing with CMS before the ICD-10 transition.

Your practice or clearinghouse can conduct acknowledgement testing at any time with your Medicare Administrative Contractor (MAC).  Testing will ensure you can submit claims with ICD-10 codes.  During a special “acknowledgment testing” week to be held on June 2015, you will have access to real-time help desk support.  Contact your MAC for details about testing plans and opportunities.

What this means for smaller independent practices (from our perspective)

First – if you feel you aren’t prepared, there is no time like today to get started.

What do you need to do to get prepared?  That answer is different for each different practice, but we have some resources available for you.  Use the ones that fit best with where you are at.

ICD-10 Planning Tools

ICD-10 Webinar Series – A few months back we hosted a series of ICD-10 webinars.  You can access the recordings now by clicking here.  In these 4 short webinars (each recording is between 30 to 45 minutes) we provide a lot of information to help with planning, to help you learn how to use the ICD-10 tools that are built into Medisoft v20/v19 and Lytec 2015/2014, how to conduct testing with your clearinghouse, and give other tips on how to become ICD-10 ready.

Quick ICD-10 Planning Checklist – This 1 page (front and back) checklist summarizes in simple terms what you need to consider for your practice to get ICD-10 ready.

ICD-10 Impact Summary – This 1 page (front side only) info sheet summarizes how ICD-10 might impact different aspects of your practice to help you understand what changes you might need to make.

Roadto10.org – They have some videos you can watch, a “Build Your Action Plan” tool you can use and many other articles and other resources.

Second – you need to upgrade to the ICD-10 ready version of your software.

Your software is not ICD-10 ready if you are not on Medisoft v20/v19, or Lytec 2015/2014.  Medisoft v18 or any other earlier model is not ICD-10 ready.  Lytec 2013 or any other earlier model is not ICD-10 ready.

Call us today at (888) 799-4777 to get your ICD-10 ready software.

Third – consider additional software solutions to help make the transition easier.

In addition to upgrading to Medisoft v20 or Lytec 2015, there are additional tools that can help make things easier.  Fact number 3 above provided by CMS states that electronic tools are available to help you with code selection.  Here are the tools that we have to offer.

Codes on Disk

If your time is valuable then you are going to truly appreciate this simple tool.  Import the latest CPT-4, ICD-10, and HCPCS codes for your specialty into Medisoft or Lytec to assist you with implementing the standard code set requirement for HIPAA.  Save yourself hours of manual labor entering all those procedure and diagnosis codes.  This tool can be used by existing Lytec and Medisoft users alike.  It will not erase your existing codes.

Encoder Pro

Encoder pro enables users to simultaneously search across ICD-10, CPT, and HCPCS codes to get integrated search results, code details, and descriptions.  This will save so much time compared to searching a physical code book by hand.  If you have Google or Bing at your fingertips, would you ever go pick up a phone book or encyclopedia or dictionary?  Take advantage of Encoder Pro the way you use Google to find things out.

EMR

Has your practice implemented an EMR yet?  If you are not using EMR yet, let ICD-10 be another reason to consider it.

How can EMR help with ICD-10?  The short answer is that we cover 5 ways an EMR can help make the transition to ICD-10 easier in our webinar series mentioned above.  Feel free to watch the webinar recordings.

Still not really a direct answer, but here are two questions to consider to get you started thinking about it.

Question 1: What is your paper superbill going to look like with the expanded list of codes you will use in your practice?

Question 2: With an increased need for documentation, how are you going to retrain yourself or your staff to be better at documentation?

With the transition to ICD-10, even though you won’t need to use all 68,000 codes, you will definitely see an increase in the number of codes you are using on a regular basis.  This could significantly increase the size of your superbill.  If you are seeing patients with a four or eight page superbill, how fun will that be to manage?

By implementing an EMR, you will make the switch to an electronic superbill which will be so much better for managing all those codes.  Additionally, the documentation needed with your ICD-10 claims will be taken care of for you while using the EMR program.

There are several other ways an EMR can help with ICD-10, which are covered in our webinar replay you can watch.  And of course EMR helps in many other aspects with amazing tools like e-prescribing, lab-interfaces, eliminating paper charts and helping to improve patient care to name just a few.  To learn more about our Medisoft and Lytec EMR options or to schedule a demo, just give us a call!

Lastly – practice using ICD-10 codes starting ASAP!

Practice!  Practice!  Practice!

Even if you have all of the tools that you need, if you wait until October 1 to start using everything, then it will be a rough transition.  If you haven’t worked out your own kinks, then you could see significant delays in getting your claims paid and you will be frustrated with the process.  Don’t do that to yourself.  You can start practicing today!

Here are a couple tips to help you start practicing.

Our second webinar recording shows you how to put your software (either Lytec or Medisoft) into “testing mode” so that you can submit test claims.  In our third webinar, we outline how you can test your ICD-10 claims with your clearinghouse.  We provide specific information from Relay Health because that is our preferred clearinghouse, but we give you the info you need so you can enquire with your own.

There is also a feature in your ICD-10 version of the program that allows you to just start coding everything in ICD-10 right now, but your claims will still be submitted in ICD-9 right up until September 30th!  In the program, you can set a date for when to start submitting your ICD-10 claims.  Set that date right now so you don’t need to worry about making any changes on the morning of October 1.  

Doing all this will allow you to practice coding in ICD-10 now and so that you and your staff can get comfortable with the changes, but without the added stress of potentially delayed payments.

That’s it for now.

If you’ve been working on getting ICD-10 ready at your practice – feel free to share your successes or your failures with the community so we can learn from each other.  Share with us in the comments below!

Announcing ICD-10 Training Webinars

Are you a small, independent medical practice or billing company?  Do you need some help getting ready for the ICD-10 transition?

With the ICD-10 transition right around the corner, we want to make sure that everyone is ready.  This webinar series is designed to help everyone get ready!

From these webinars you will learn:

  • The basics and background of ICD-10.
  • What new challenges you will have with billing because of ICD-10 and what your software (either Medisoft v20 or Lytec2015) will do for you to overcome these challenges.
  • All about testing submitting your claims so that you will feel confident going into October.
  • What you can do to make the transition to ICD-10 as easy as possible.

If you need practical and easy-to-understand information specific for your software (Medisoft or Lytec) to help you prepare for the October 1 deadline, then this is exactly what you are looking for.

Take a moment now to learn more about the webinars and to register.

Click Here for ICD-10 Webinar Information and Registration

As part of your ICD-10 implementation plan, you will need ICD-10 ready software for your practice.  Give AZCOMP a call at (888) 799-4777 to talk with a Software Specialist when you are ready to buy Medisoft v20, or Lytec 2015 or integrated EMR systems.

AZCOMP has been a Leading Software Partner for 15 years!  Coincidence… We Don’t Think so!

Here’s why Small Practices Partner With AZCOMP:

Small Independend Medical Practice Technology Partner

We Are Technology Partners

We don’t just sell software.  We understand the challenges Small Practices face & we find powerful solutions to help!  We’ve helped thousands of practices become more efficient, increase revenue, and most importantly – improve patient care.

Medical Billing Software Guru's

Lots of Medical Billing Software Guru’s

We are NOT a one man show.  We have specialized teams who know the software inside and out.  Each team is highly qualified in their area- like Software Support, Training, Installation, IT…  Let’s just say that the software companies are coming to us when they need help!

Medisoft Training; Lytec Training

Expert Training – For FREE!

It’s no secret that the happiest and most efficient Software users are those properly trained.  So we make sure that our customers get the expert training they need & won’t find anywhere else- like Free Tips and Tricks videos on our blog, webinars, and our popular Training DVD’s.

Lytec Mobile App for Lytec 2015 Demo Video

Introducing the all new Lytec Mobile App for Lytec 2015 – Watch the Demo below…

New Lytec iPad AppHave you ever wished there was a way to have your patients just put all their demographics and insurance information into Lytec for you?  If they could just type it all in, then you wouldn’t have to try to interpret all of their bad handwriting.  With the new Lytec mobile app, this is now possible.

Just imagine being able to hand an iPad or Android tablet to a patient when they come in and then they can enter all their demographics and insurance information straight into Lytec for you.

Plus it gets better.  Also imagine the Dr. can enter all charges on an electronic superbill using the mobile app.  This information will be immediately available in Lytec to the biller who no longer has to re-key the information or deal with illegible handwriting on the old paper superbill.  This makes it so that the biller will be able to submit claims 60% sooner than before.

Huge End of the Year Savings For Lytec 2015 Going On Now!

If you buy Lytec 2015 now or up till the end of the year, you can cash in on huge promotional savings.  Call in to (888) 799-4777 to talk to a Lytec Specialist to see how much you can save.  One thing for sure is that AZCOMP continually has the best deals for Lytec, so call today to find out how much we can save you.

For more details on many more of the available features of Lytec 2015, visit our Lytec page.

Have you started your transition to ICD-10?

ICD-10 is coming and it is going to require some massive changes.  If you have not really thought about it yet, you need to start making a plan.  The first thing you need to do is download our ICD-10 checklist to help you make a plan – and start working on your plan!

Secondly, you need to have software that is capable of handling those changes.  Lytec 2015 is ICD-10 ready.  PLUS, it has tons of really helpful tools (like the code mapping feature) to make the transition easier and as smooth as possible.

Would you like to see a demo of the Lytec Mobile App?

The all new Lytec mobile app is compatible with Android tablets and Apple iPad’s.  This demo video will show you how you can use this awesome tool to capture patient information before an appointment, and how the Dr. can use it to help streamline your offices workflow.

Remember – right now is the time to buy Lytec 2015 because the savings of the current promotion will not last long.  Call AZCOMP now at (888) 799-4777 to speak with a Lytec specialist and secure your copy of ICD-10 ready Lytec 2015.

If you have any questions or would like to leave a comment – you can do that below and we’ll be sure to respond to your questions.

News From CMS Regarding ICD-10 Testing Week

This Past March, CMS Conducted A Successful Test Submitting Claims Using ICD-10 Codes

In an article published by the Centers for Medicare & Medicaid Services (CMS) on May 30, 2014, CMS states that with the use of 2,600 different participating providers, supplier, billing companies and clearinghouses, over 127,000 claims were submitted using ICD-10 codes to the Medicare Fee-for-service (FFS) claims system.

CMS states that the test week was successful because nationally, CMS accepted 89% of the test claims, with some regions reporting acceptance rates as high as 99%.  “This testing week allowed an opportunity for testers and CMS alike to learn valuable lessons about ICD-10 claims processing.  In many cases, testers intentionally included such errors in their claims to make sure that the claim would be rejected, a process often referred to as negative testing.”

Make sure you are keeping up to date with all of the latest news from CMS regarding ICD-10 by subscribing to their email notifications.  Or just visit their website regularly to get all sorts of good information on transition planning, timelines and all manner of good resources that should help your practice prepare for ICD-10 implementation in 2015.