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From Health Law Daily, March 13, 2014

CMS launches website to help small practices adopt ICD-10

By Patricia K. Ruiz, JD

Small practice physicians now have access to “Road to 10,” CMS’s newly launched website, which was designed with the goal of helping such physicians understand and implement the ICD-10 diagnostic and procedure codes in advance of the October 1, 2014, compliance deadline. Through the “Road to 10” website, physicians and practices unfamiliar with ICD-10 can learn about the ICD-10-CM code structure and indexes or use the website’s charts to keep abreast of the coding changes. The importance of implementing ICD-10 is detailed on the website, as well as other important considerations in the process.

Implementation and compliance. The implementation of ICD-10 affects all HIPAA-covered entities, whether or not they serve Medicare beneficiaries. Compliance, which is mandatory for these entities, requires the utilization of ICD-10 codes for health care services provided on or after the October 1, 2014, deadline. After the deadline, ICD-9 codes become obsolete and will be rejected. Coders must verify with their certification association to determine whether additional certification is needed.

ICD-11 gap too large. The FAQs on “Road to 10” states that, the choice to implement ICD-10 rather than skipping to ICD-11 is largely a matter of timing, as “skipping directly to ICD-11 implementation could take too long.” ICD-9, which was published in 1978, was not followed by the endorsement of ICD-10 until 1990. Then, ICD-10 adoption was not proposed until 2008. Based on this history, even with the release of ICD-11 slated for 2015, it would not be implemented in the United States until 2039. The delay in implementation could be even larger, according to the FAQs, considering that the gap between ICD-9 and ICD-11 is much larger than the gap between ICD-9 and ICD-10. The FAQs note that implementing ICD-11 at this point “would be an even larger and more dramatic undertaking” for small practices, as well as for the US health care industry as a whole.

Small practices and ICD-10. ICD-10, according to the website, “will provide an enhanced platform for physician practice.” “Road to 10” breaks down the potential benefits for physicians into four categories: clinical, operational, professional, and financial. The clinical benefits of ICD-10 compliance include more informed clinical decisions, improved tracking of illnesses and severity over time, and improved public health reporting. Operationally, physicians can benefit from more targeted capital investment, enabling physicians to meet the needs of the practice “through better specificity of patient conditions.” The professional benefits include the prevention and detection of health care fraud and abuse, and, financially, practices can improve documentation for the support of reimbursement.

Action plan. The “Road to 10” website allows physicians to create an action plan, in which implementation, training, updating, and testing can be detailed. In the creation of an action plan, physicians also have access to tools for collaborating with payers and vendors. Templates for ICD-10 action plans—including process and system inventories as well as assessments for technology vendors, billing services, clearinghouses and payers—can be found in the “Road to 10” website’s template library.

MainStory: TopStory ComplianceNews EHRNews BillingNews CMSNews QualityNews

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