President signs bill into law to delay ICD-10 Implementation until 2015
On April 1, 2014, President Obama signed a bill into law which delays the mandated move from ICD-9 to ICD-10 code sets by one year. The bill prohibits CMS from "enforcing" the ICD-10 mandate prior to Oct. 1, 2015.
Florida Blue's ICD-10 initiative consists of a full remediation strategy and is proceeding on plan for completion this Oct 1, 2014. We are continuing our provider testing and outreach efforts and will be ready to accommodate ICD-10 according to the latest federal regulatory guidelines. You can rest assured knowing Florida Blue is here to assist you in preparing for ICD-10 implementation.
The International Classification of Diseases (ICD-10) Clinical Modifications (CM) and ICD-10 Procedure Coding Structure (PCS) are new medical code sets under HIPAA-AS and represent a fundamental overhaul to the current ICD-9 coding system. A federal mandate requires all HIPAA covered entities adopt ICD-10 by a compliance date not to precede October 1, 2015.
ICD codes are used to codify medical diagnosis and procedures; calculate and adjudicate coverage; compile medical statistics; assess quality of care and help manage clinical quality outcomes for patients. The current ICD-9 codes sets are outdated & do not reflect advances in medical technologies nor are they descriptive enough.
The new ICD-10 CM and PCS classification system is being implemented to provide:
- Improved patient care quality because of greater detail and an increased ability to accommodate new technologies and procedures.
- Richer medical data with higher degrees of detail and quality for further analysis; helps to enrich clinical care profiles and patient outcomes.
- Enhanced claim processing by requiring more detailed information in the diagnosis and procedure code assignments.
- Increased interoperability across industry stakeholders worldwide by phasing out aging and inflexible technical systems.
Frequently Asked Questions
Click here for Florida Blue specific ICD-10 readiness FAQs.
What happens if I do not switch to ICD-10?
Providers can begin to prepare by taking the following steps NOW:
• Talk with your billing service, clearinghouse, or practice management software vendor NOW
• Identify ICD-9 (and presumably ICD-10) touch points in your systems and business processes
• Identify needs and resources, such as training, printing, etc.
An ICD-10 transition plan should take into account specific practice or organization needs, vendor readiness, and staff knowledge and training.
Providers should check with their billing service, clearinghouse, or practice management software vendor about their readiness plans.
Providers who handle billing and software development internally, should plan for medical records/coding, clinical, IT, and finance staff to coordinate on ICD-10 transition efforts.
Work together to make sure you’ll have what you need to be ready. A successful transition to ICD-10 will be vital to transforming our nation’s health care system and essential to maintaining business operations.
CMS has resources to help providers prepare for a smooth transition to ICD-10. Visit www.cms.gov/ICD10 to find out more. CMS will continue to add new tools and information to the site through the course of the transition.
Where can I find your latest ICD-10 Provider Pulse Survey Results?
Results to our 2013 ICD-10 Provider Pulse Survey are available in the Jan. 17, 2014 Open Line Friday provider teleconference presentation (here).
When is the ICD-10 compliance date?
On April 1, 2014, President Obama signed a bill into law which delays the mandated move from ICD-9 to ICD-10 code sets by one year. The bill prohibits CMS from "enforcing" the ICD-10 mandate prior to Oct. 1, 2015. Further regulatory guidance from CMS is forthcoming.
If I transition early to ICD-10, will CMS be able to process my claims?
The transition to ICD-10 is a major undertaking for providers, payers, and vendors. It will drive business and systems changes throughout the health care industry, from large national health plans to small provider offices, laboratories, medical testing centers, hospitals, and more. Plans need to devote staff time and financial resources to transition activities. The transition will go much more smoothly for organizations that plan ahead and prepare now. A successful transition to ICD-10 will be vital to transforming our nation's health care system and ensuring uninterrupted operations.