Something Wicked This Way Comes: The ICD-10 Deadline is Here

Ready or not, the ICD-10 changes are about to go full force on October 1, 2015. As a professional healthcare consulting firm, MD Pro Solutions has helped many practices get prepared for the ICD-10 deadline through training, software updates and support. If your practice is not fully ready for the change at this point, you need to get in touch with a service that will help you with your otolaryngology billing and coding right away to ensure that you do not suffer serious delays in filing claims. You are not alone – current studies show that only a fraction of practices nationwide are prepared for the impending change, but it is important that you do what you can right now.

ICD-10 Deadline Testing: Are You Ready?
Many medical practices think that they are properly prepared for the ICD-10 changes to take effect in October, but are they really? Even the American Medical Association (AMA) is suggesting that practices, clinics and hospitals do three things to make sure that they are ready. When it comes to taking care of otolaryngology billing and coding, it is important to make sure that your team is ready to make the switch so you won’t have any delays in filing claims and that you won’t experience a slowdown in cash flow.

The three things that the AMA suggests practices check include:

• the ability to properly submit, receive and process data that uses the ICD-10 codes
• having an understanding of how the ICD-10 changes affect submitted transactions
• the ability to identify and address any specific issues you are having

Working with a professional healthcare consulting firm like MD Pro Solutions can help you with the testing that is required to determine whether or not you will be ready by the ICD-10 deadline. Testing is a very important part of the process and will help you to resolve any problems that you are having during the “claims creation process,” which starts at the documentation phase and goes all the way through claims submission.

There are three different types of testing that can be done including content-based testing, internal testing and external testing. They will help answer the three items listed above from the AMA to help you learn whether or not your otolaryngology billing and coding is ready for the ICD-10 changes on October 1st.

What You Need to Know
If you have any concerns at all about the ICD-10 deadline and whether or not your medical practice is prepared and ready to go, contact a healthcare consulting firm and get some help. The truth is that while the ICD-10 changes have been delayed several times over a period of years, they will not be delayed again. The October 1, 2015 deadline is firm. While some minor allowances are being made by the AMA and Centers for Medicare & Medicaid (CMS), the changes to otolaryngology billing and coding will happen and practices must comply.

It is important to note that any Medicare claims that have a service date that is on or after October 1, 2015 will be rejected if they do not contain an ICD-10 code that is valid. You should at least have an understanding of the “family of codes,” which is the three-character category that is used to describe a specific type of condition. Each family contains a number of more specific codes that are used to describe more details about the condition and treatment being given. CMS has stated that Medicare B claims that have the appropriate family of ICD-10 codes listed will not be denied or subject to audit solely based on the diagnosis codes. This is about as flexible as they are going to be with the ICD-10 deadline.

Certain claims could still be denied if the ICD-10 code is not consistent with an applicable policy or to claims that were authorized prior to or had a prepayment review before the deadline. The flexibilities extended by CMS only apply to claims processing or to post-payment reviews. Also, it is important to note that the CMS changes will not affect Medicaid or commercial payers, but only Medicare fee-for-service claims made by physicians and other practitioners that fall under the Medicare fee-for-service Part B schedule.

Call MD Pro Solutions for ICD-10 Deadline Help
If you have any questions or concerns about your practice’s ability to meet the ICD-10 changes in time for the October 1, 2015 deadline, or if you aren’t sure whether or not you qualify for the allowances provided by CMS, contact MD Pro Solutions. We are a full service healthcare consulting firm that specializes in otolaryngology billing and coding. Our team is highly trained and experienced in the Ear Nose and Throat field, so we are able to help you with any specific issues or problems you might have. Give us a call today at 508-946-1665 for more information on our services or to inquire about a consultation.