Otolaryngology Management and the ICD-9 to ICD-10 Conversion

Healthcare providers have been given an extra year to get all of their medical billing and coding prepared to make the ICD-9 to ICD-10 conversion. What will you do with the extra time? Many providers were not ready for the conversion, in fact many medical billing solutions and services have been working overtime to ensure that their clients are prepared for the official switch, which will now take place on October 1, 2015. The latest information shows that there will be about 18,000 code sets that will be switched out for approximately 155,000 codes currently being used for billing and collecting from patients.

What is the ICD-9 to ICD-10 Conversion?
The pending change to ICD-10 will be a requirement for all medical billing and coding from health care providers and insurers that are covered under HIPAA to submit claims to Medicare or Medicaid. The code, which was designed to help track mortality, diagnoses and treatments worldwide by the World Health Organization (WHO) back in 1992, has undergone many changes since it was first released. Additional coding has been added throughout the years, but the latest implementation was designed to reduce some of the confusion across the healthcare industry.

Unfortunately, it has had quite the opposite effect. Many practices, clinics, hospitals and insurers have become even more confused by the massive changes associated with the ICD-9 to ICD-10 conversion. As a result, the transition has been pushed back many times. Originally proposed back in August of 2008, ICD-10 code sets were supposed to have been adopted by October 2011, giving the healthcare industry over three years to make the changes to medical billing and coding. However, there were thousands of comments and complaints made by people within the medical billing and coding industry and it was agreed that providers would have until October 2013 to implement the changes.

More Delays…
In August 2012, the deadline for compliance with the ICD-9 to ICD-10 conversion for Otolaryngology management and other healthcare management organizations was pushed back again another year to October 2014. The reason for this delay was due to concerns expressed by healthcare providers about not being able to meet the 2013 deadline. Several months before the 2014 deadline, it was announced at the Healthcare Information and Management Systems Society (HIMSS) convention that no more delays would occur and that the new system for medical billing and coding would go online on October 1st.

Testing began in March 2014 to ensure that the ICD-10 codes used with Medicare claims would be accepted. 127,000 of those claims, which was just under 90 percent of those that were tested, were accepted by processing testers, which included providers, billing companies, suppliers and claims clearinghouses. But just a month later on April 1, 2014, President Obama signed a legislation that would push back the ICD-9 to ICD-10 conversion back to October 1, 2015 as part of a larger legislation that was designed to delay Medicare payment cuts for doctors.

What Do the Delays Mean?
By delaying the conversion for medical billing and coding across the board, many hospitals, clinics and medical practices who were not yet ready to be compliant with ICD-10 benefited. It is unknown exactly how many practices within Otolaryngology management are currently unprepared or in the process of making the transition. As a result of all these delays, the pending release of the final version of ICD-11 codes will now not be released until 2017, a full two years later than originally expected. If any more delays occur, it could definitely impact the future of ICD-11 and medical billing solutions across the board.

Organizations within the healthcare industry need to take this latest “bonus” year to get their act together, figure out what they must do in order to be compliant with the ICD-9 to ICD-10 conversion or hire professional medical billing and coding services to do it for them. If they are not prepared and the October 1, 2015 date is maintained, they could be facing penalties and would be unable to do any billing and collecting from patients, causing huge issues within the healthcare industry as a whole. It is very important for organizations to work diligently to learn all of the new medical billing and coding required to make the transition and implement those changes to protect their practices.

How MD Pro Solutions Can Help
If you work in the area of Otolaryngology management and administration, MD Pro Solution can help you with your medical billing and coding for the ICD-9 to ICD-10 conversion. Our team specializes in providing medical billing solutions for clients who specialize in providing Otolaryngology services to their patients. It is our goal to help Ear Nose and Throat clinics to run effectively and efficiently, while staying on top of the best practices associated with billing and collecting from patients. Use our online form or give us a call at 508-946-1665 to learn more about all of our medical billing solutions and services.