Becker's ASC Review

87 As with all software, bugs are often inevitable. And these predictable glitches only underscore the importance of troubleshooting as soon as possible patches can be obtained and deployed, if necessary. Facilities may also encounter additional costs in updating these systems, and outside IT consultants may be required to implement the updates. Coding According to the June AHIMA survey, roughly 70 percent or more of all providers had distributed to staff ICD-10 awareness and educational materials, assessed readiness internally and prepared for implementation, and provided ICD-10 staff training. Providers can take advantage of this head start by requiring staff to code in both ICD-9 and ICD-10 between now and Oct. 1. Dual coding allows managers to troubleshoot potential problems and identify areas for im- provement well before they become a costly mistake. Delayed reimbursement has been a major source of heartburn for ASCs and other providers heading toward the deadline. at's why providers breathed a collective sign of relief in July, when CMS announced it was soening its stance on claims denials for Medicare until 2016, promising not to hold up reimbursements if coders use the correct ICD-10 family code. "While diagnosis coding to the correct level of specificity is the goal for all claims, for 12 months after ICD-10 implementation, Medicare review contractors will not deny physician or other practitioner claims billed under the Part B physician fee schedule through either auto- mated medical review or complex medical record review based solely on the specificity of the ICD-10 diagnosis code as long as the physi- cian/practitioner used a valid code from the right family," CMS wrote in published guidance. Payers As of press time, it was uncertain whether major commercial payers would follow Medicare's lead and implement a similar coding grace pe- riod. With that in mind, ASCs and other providers should assume Oct. 1 is a hard-and-fast deadline for the ICD-10 transition, especially for major payers that appear to be well prepared for the ICD-10 transition. As of winter 2014, about 80 percent of health plans surveyed had started internal ICD-10 testing, according to WEDI. In addition, more than half also had begun external testing by last February, while 40 percent expect- ed to start by July 1. Yet, smaller regional payers may still require ICD-9 codes aer the dead- line, so it's important to follow-up with all familiar health plans about pos- sible last-minute policy changes that may result in reimbursement delays or claims denials down the road. CMS is offering a variety of ICD-10 testing programs that allow providers to troubleshoot various aspects of their revenue cycles in the run-up to the fall deadline. e agency conducted three separate end-to-end volunteer testing opportunities in 2015 that allowed providers to successfully sub- mit claims containing ICD-10 codes to the Medicare FFS claims systems, adjudicate claims appropriately using CMS soware updated for ICD-10, and produce accurate RAs. While the last CMS end-to-end testing period concluded in July, provid- ers may still utilize acknowledgement tests to troubleshoot their systems through the Oct. 1 deadline. is helpful, simple tool allows providers to submit ICD-10 codes and receive acceptance – or denial – confirmation from Medicare's FFS claims systems. Your ASC's accountant will thank you for it later. n is guest column is the second in a series on ICD-10 readiness, trouble- shooting and solutions. Please look for the final installment in the next issue of Becker's ASC Review. BECKER'S SPINE REVIEW E-WEEKLY subscribe today free • educational • up-to-date Visit beckersorthopedicandspine.com or call (800) 417-2035

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