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ICD-10 Codes: Helpful Resources to Get You Up to Speed

October 2, 2013

It may be surprising to you, but federal legislation drives a lot of what we do at EPOWERdoc. From some of the more well known pieces of law like HIPAA to the somewhat recent roll-out of the HITECH Act of 2009, we have a unique strength in molding solutions that ensure our clients are compliant with the myriad rules and regulations that come out of Washington, D.C.

That said, we still encourage our clients to maintain a working knowledge of how various regulations will affect them. And one regulation that is fast approaching and demands the attention of those who work in the inpatient world -- from EMR providers like us to frontline staff in hospital accounting -- is the roll out of ICD-10 codes.

The new regulations from the Department of Health and Human Services (HHS) have been a long time coming. According to data cited by the American Medical Association (AMA), the ICD-9 code set is over 30 years old and has become outdated. It is no longer considered usable for today’s treatment, reporting, and payment processes. It does not reflect advances in medical technology and knowledge. In addition, the format limits the ability to expand the code set and add new codes.

And while the transition to ICD-10 codes was not passed through Congress, it still carries the weight of law. According to the Centers for Medicare and Medicaid Services (CMS), claims for all health care services and hospital inpatient procedures performed on or after October 1, 2014, must use ICD-10 diagnosis and inpatient procedure codes. (This does not apply to CPT coding for outpatient procedures.) Claims that do not use ICD-10 diagnosis and inpatient procedure codes cannot be processed. It is important to note, however, that claims for services provided before October 1, 2014, must use ICD-9 diagnosis and inpatient procedure codes.

In a handy FAQ developed by the AMA they go on to report that the ICD-10 code set reflects advances in medicine and uses current medical terminology. The code format is expanded, which means that it has the ability to include greater detail within the code. The greater detail means that the code can provide more specific information about the diagnosis. The ICD-10 code set is also more flexible for expansion and including new technologies and diagnoses. The change, however, is expected to be disruptive for physicians during the transition and you are urged to begin preparing now.

There are no doubts that this is a huge undertaking. So huge, in fact, that the implementation was delayed a year and pushed back to October 1, 2014.

Which means everyone has a little more time to study up on how the move will impact them. To assist you in learning more about ICD-10 codes and their impact, here is a resource:

American Medical Association FAQ

http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.page

To learn more about EPOWERdoc solutions that ensure a smooth transition, call a member of our professional staff at 515.965.8040 or email jporter@epowerdoc.com.

About EPOWERdoc

EPOWERdoc is a leader in computerized Emergency Department Information Systems (EDIS), using a design team comprised of emergency physicians and nurses. Additionally, EPOWERdoc provides superior medical content for other vendor EMR builds. As it was from the beginning, the EPOWERdoc mission is centered around excellence, integrity and service. Every employee is committed to going above and beyond in meeting the needs of the client, while focusing on the specialized needs of the physicians, nurses and hospitals they serve.

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