As of October 1, 2015, ICD-10 medical diagnosis coding will forever replace ICD-9. Any ICD-9 codes submitted after the last day of September will be, in most cases, rejected. If your healthcare practice is not prepared for the transition, your cash flow may come to a screeching halt. Your rejection and exclusion reports could increase from 1 out of 10 claims, to as high as 8 in10. Claim formatting from 4010 to 5010 will accommodate the additional character/field requirements as further diagnostic code specificity is required (more digits) beyond the decimal point.
To avoid catastrophe with the conversion to ICD-10, you need a partner who is experienced and knowledgeable in the many new and changing requirements of the healthcare industry. Commonwealth Medical Management Services, Inc. (CMMS) can provide you with a host of services and solutions to ensure a seamless transition to ICD-10. In fact, we are in the 99th percentile for ICD-10 preparedness. With our programs and services, including ICD-10 End-to-End Testing, CMMS’s existing client base is always given the peace-of-mind that testing and preparation for big changes such as ICD-10, are rarely if ever, a concern. “We are always trying to stay one-step ahead of the game – which isn’t always easy in this ever-changing marketplace”, says Whitehurst, President – CEO, CMMS, Inc.
ICD-10 Claims > Clearinghouse > to Carrier > and BACK: = End-to-End Testing (E2E Testing).
The medical coding process starts when a claim is submitted to a clearinghouse. Once an initial check for errors is completed and the claim is successfully received by the clearinghouse, the claims begin to be parsed to their corresponding carriers. ICD-10 formatting will be checked by the clearinghouse and again by the carrier systems. If your ICD-10 test (formatting and codes) are appropriately handled, the carrier will acknowledge the claim and return an explanation of benefits (EOB) to the electronic remittance module. Result = E2E testing.
CMMS began preparing for ICD-10 months ago. Online Charge slips have been or are in the process of being re-built, specific carrier and E2E testing is 90% complete. What has your billing partner done for you?
CMMS can be your healthcare organization’s partner for ICD-10 readiness and all things “Healthcare Compliant”. Maximizing cash flow by utilizing “Industry Best Practices” is what CMMS is best known for. To streamline your healthcare organization, contact CMMS today.