As predicted, the transition to ICD-10 has slowed down the industry as a whole. Our processes have also been impacted and we are not current submitting charges with the payers. You may notice you may have charges which did not make your End of Month closing. ICD-10 has caused us to literally research each and every charge that has come in. Even those apparent, simple, repetitive billings are no longer simple and repetitive. Our coders are working diligently to overcome the learning curve and deal with this huge transition (as ICD-9 has about 17,000 codes and ICD-10 now has 70,000 code options).
As a reminder, it is very important our providers are sending all the necessary details of the diagnosis for each case, including, but not limited to; upper, lower, left, right, bilateral; acute, chronic, or recurrent; anatomy – femur, knee, maxillary, ulna; initial, sequel, or subsequent; etc. As you can imagine, diagnosis options expanding from 17,000 to 70,000, details required to accurately report have exploded. “Cataract” is no longer an acceptable diagnosis. We must now report which eye and the cause for the cataract. When information sent is not descriptive enough, the coding assigned lack specificity and could cause denials of claims, delaying revenues even longer. Once a denial is received, we will be required to obtain medical records to submit for payment.
Please help us by ensuring the amount of descriptive information you are sending for the diagnosis is sufficient to code properly. It appears now, things will catch up or settle out by the end of the year for the industry. If you have questions or need assistance to determine if what you are sending is sufficient, please contact our office.
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Editor: Philip Blann (pblann@anesthesiabilling.com).
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