From Your Billing Pro: Understanding ICD-10 Transition

March 14, 2014 bhbhub

From Your Billing 2

Understanding ICD-10 transition (part 1)

What is ICD-10?

ICD-10 (International Classification of Diseases, 10th Editon, Clinical Modification/Procedure Coding System) consists of two parts for diagnosis and inpatient procedure coding. Diagnosis coding under ICD-10 uses 3 to 7 digits instead of 3 to 5 digits used with ICD-9 and the format of sets is similar.

Why is ICD-10 being substituted for ICD-9, which is currently in use?

ICD-9 produces limited data about patients’ medical conditions and hospital inpatient procedures. In addition ICD-9 has several limitations that prevent complete and precise coding and billing of health conditions and treatments.

ICD-10 implementation is the biggest data change ever in the healthcare industry. It represents significant changes for every aspect of healthcare—effecting systems, procedures and workflow across the healthcare enterprise. 

Why is this important to behavioral health providers?

ICD-10 will affect diagnosis and inpatient procedure coding for everyone covered by HIPAA and because all of the services provided for behavioral health are subject to HIPAA standards, treatment providers must shift to ICD-10 on October 1, 2014.

What should a provider be doing to prepare for ICD-10?

I recommend developing an implementation strategy that includes an assessment of the impact on your organization, a detailed timeline, and a budget. Check with your billing service, clearinghouse, or practice management software vendor about compliance plans. It is important to implement staff training on the use of ICD-10 codes, modifications to your billing procedures, and to determine if your electronic health record provider is making the system updates that will be ICD-10 compliant by October 1, 2014.

Some of this information was provided by

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