Presenters: Kristie Gilbert and Jewell Froisland
Q: If you don’t bill Medicare or Medicaid, do you still have to change ICD-10?
A: If you are covered by HIPAA (Health Insurance Portability Accountability Act), then yes, you must make the change to ICD-10.
Q: What happens if my office doesn’t switch to ICD-10?
A: If a service is provided on or after Oct. 1, 2014, the claim must have ICD-10 codes or it will not be paid. Please note, the version to use (ICD-9 or ICD-10) depends on the DATE OF SERVICE, not the date the bill goes out. So, if the patient was seen on Sept. 30 and the bill goes out on Oct. 2, you would need to use the ICD-9. This is the same for hospitalized patients. For any service provided prior to Oct. 1, 2014, you will need to submit ICD-9 codes and the services on Oct. 1 and following will need to be from ICD-10. Check with your payers to see if they want them billed together or on separate bills.
Q: Can we start using ICD-10 codes now if our system is ready?
A: No, you will need to wait until Oct. 1, 2014. You should, however, be testing with your vendors and payers to be sure your systems are compatible.
Q: Will ICD-10-pcs replace CPT?
A: No, CPT codes are not going away. Continue to use them as you have in the past, including the modifiers. And, oh yeah, make sure the laterality on the ICD-10 code matches the laterality on the CPT code modifier. Don’t want to send out a bill for a cast on the right arm when the dx code says the left arm is broken!
Q: What does the ACI filter Limit ICD search to preferred base do?
A:This filter only affects the results when you are searching by ICD code. When selected, only the preferred ICD code is returned in the search results. When not selected, all codes matching the search criteria are returned in the search results. Basically, you will not be returning the secondary codes as well if checked.
Q: Are all insurance companies are going to require ICD 10?
A: If an insurance company is covered under HIPAA (Health Insurance Portability and Accountability Act--this is what mandated the change to ICD-10), then they MUST use ICD-10 starting October 1, 2014. Non-covered entities such as Workman's Comp and auto insurances are not required to, but are strongly encouraged make the change.
Free ICD-10 training: http://apps.who.int/classifications/apps/icd/icd10training/
AAPC:(Note: some info on this site requiresa membership.) http//www.aapc.com/icd-10/
CMS (Center for Medicare Services): http://www.cms.gov/Medicare/Coding/ICD10/index.html?redirect=/icd10