ICD-10 is finally happening

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 - Beth Walsh - Portrait
Beth Walsh, Editor

There were multiple delays. There were conflicting survey results on whether healthcare organizations were adequately prepared. There was end-to-end testing, guidance, tools and much debate.

The American Medical Association (AMA) in particular fought the transition, citing the costs for an effort that would have little impact on patient care.

But, the Oct. 1 deadline stuck this time and the AMA finally shifted from fighting it to efforts to help physicians get ready.

The Centers for Medicare & Medicaid Services (CMS) released additional guidance allowing for flexibility in the claims auditing and quality reporting process as the medical community gains experience using the new ICD- 10 codeset.

CMS also agreed to a one-year grace period during which Medicare claims will not be denied solely on the specificity of the ICD-10 diagnosis codes provided as long as the physician submitted an ICD-10 code from an appropriate family of codes. Medicare claims also won’t be audited based on the specificity of the diagnosis codes as long as they are from the appropriate family of codes.

CMS named an ICD-10 Ombudsman to triage and answer questions about the submission of claims as well.

So, after years of tension and back-and-forth the Oct. 1 transition data has come and gone. Soon we’ll know what kind of impact the change has had on claims and reimbursement.

Revenue cycle firm RelayHealth just announced that about $25 billion worth of ICD-10 claims "are flowing succesfully.” 

There is still time for trouble. RelayHealth continues “to anticipate a groundswell of issues in getting claims out the door and an increase in denials and rejections."

So, all the comparisons to Y2K may have been prophetic since that transition happened with little upset.

Who wants to talk about ICD-11?