ICD-10 Code Warrior: Beyond October 1st

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ICD-10 Code Warrior: Beyond October 1st

In the fallout since Oct 1st, the ICD-10 Code Warrior wanders the wasteland alone…He’s been scavenging the vast and barren wasteland for weeks now- It’s been days since the bank has registered a deposit for the practice… He searches the charred landscape in a hopeless hunt for clearing house response for reimbursement. He falls to his knees, looks up to the burning sky and with his last breath curses the day we ever had to switch to ICD-10.

Except that none of that ever happened, or has to, because the transfer to ICD-10 didn’t bring about the end of the world (Which is almost a shame, considering a whole directory of new codes just in case the zombie apocalypse ever happens). Actually, according to some recent numbers, it didn’t really even change much of anything in the EHR industry at all. Claim acceptance and payments are up, rejections are down, and I haven’t heard of even one single zombie sighting.

PrognoCIS customers are reporting that due to the proper training via in-house webinars, they were prepared for the switch. Payment rejections from ICD-10 are comparable to what they were during the dark ages of ICD-9, which suggests that the majority of mistakes made this month would have also been made using the previous platform’s codes. There is no data to suggest that it is due to ICD-10 and its new coding system.

All across the country, clinicians are noting that things have gone better than anticipated. Blue Cross Blue Shield of Michigan reports, “BCBSM’s ICD-10 implementation went very smoothly. Call center volumes and overall inquiries are very low. Professional and facility claims are processing as expected. A few issues noted, which we are resolving, but nothing major to report.”

Not quite the end of the world that was being described for the last two decades. For the uninitiated, work on ICD-10 began in 1983 and was finished in 1992. If ICD-10 were a person, it would be old enough to drink at a bar; it would probably be done with college by now. China, The Netherlands, South Africa, Korea, and Thailand all began using ICD-10 before 2008. The Czech Republic started using it in 1994, a mere one year after the World Health Organization (WHO) released it.

So, what happened? Why did it take over twenty years to implement? It’s a bit of a loaded question, but the short answer is that the American healthcare system is a complex animal that has many high profile and very influential special interest groups controlling the decision making of it. In August of 2008 the Department of Health and Human Service (HHS) proposed that clinicians begin using ICD-10 for transaction counting and reporting diagnoses. A few months later in January 2009, the HHS published the definitive ruling that ICD-10 would for sure be the next standard in medical coding, with an implementation date of Oct 1, 2013. And then 2013 became 2014. And just when we thought all the fear and bureaucratic red tape was cleared, 2014 became 2015.

Many blogs cited that the transition would surely amount to the “apocalypse” or bring about the “Four Horsemen.” A month into the new system, it appears that all the anxiety and trepidation about ICD-10 were a little more than unfounded. PrognoCIS was ready to keep workflow smooth and keep you out of the wasteland.

Author: Cory Clark