ICD-10 Frequently Asked Questions (Including Update on Revised CMS-1500 Form)

The following is a guest blog post by Dana Deardorff.

Are you concerned about the upcoming changes in coding? The following are answers to frequently asked questions that will help you prepare for the changes ahead. Please note the deadline for the first significant change is April 1, 2014.

What does ICD-10 stand for?

ICD-10 is an abbreviation. It stands for the International Classification of Diseases, 10th Revision. It is used when referring to either the Clinical Modification (ICD-10-CM) or Procedure Coding System (ICD-10-PCS).

How will ICD-10-CM be used?

ICD-10-CM will replace ICD-9-CM codes, Volumes 1 and 2. It will be used when reporting clinical setting diagnoses.

How will ICD-10-PCS be used?

ICD-10-PCS will be used by hospitals to report inpatient procedures.

Who has to convert to ICD-10?

Health care providers, clearinghouses, payers and physicians all are required to convert to ICD-10. This is not optional and includes any HIPAA covered entity.

What will happen if I don’t convert to ICD-10 by the October 1st deadline?

If you submit ICD-9 codes after October 1, 2014, those transactions will not be accepted. Those transactions will be denied. This will cause you to lose out on reimbursements. You may need to apply for a line of credit to prepare for cash flow disruptions that may occur due to noncompliance problems. This will help protect you from negative impact if your medical practice partners do not convert to ICD-10 in time.

What is the deadline for the ICD-10 conversion?

The deadline is October 1, 2014.

What is this April 1, 2014 deadline I keep hearing about?

The April 1 deadline is for the revised CMS-1500 form used for submission of paper claims. The CMS-1500 form is an intricate part of the ICD coding system. The new form (version 02/12) is replacing version 08/05. As of April 1, 2014 providers need to use version 02/12 of the CMS-1500 form. The old form will no longer be accepted.

How is the revised CMS-1500 form tied into the ICD-10 transition?

Physicians will notice that the revised CMS-1500 form provides fields for the new ICD-10 codes. However, your payors may not have made the transition from ICD-9 to ICD-10. Physicians should use ICD-9 codes until you have confirmed that the payor has made the transition to ICD-10. After October 1, 2014, your payors should have all made the transition to ICD-10, and you should be able to use the new codes from that date forward.

What is different about the revised CMS-1500 form?

The revised CMS-1500 form:

* Provides fields and indicators for both ICD-9 and ICD-10 codes

* Provides documentation space for up to 12 diagnosis codes

* Offers qualifiers to aid in the identification of provider roles in the furnishing of services

* Uses letters instead of numbers as diagnosis code printers

You will want to upgrade your practice management software or order 02/12 forms immediately if you have not done so already. Discard any 08/05 forms after April 1, 2014.

When should physicians start using the revised CMS-1500 form?

Providers can start using the revised form on January 1, 2014, but all providers must switch to using the revised form as of April 1, 2014. Your (PM) Practice Management/EMR/EHR practice vendor can help you determine what you need to do to remain in compliance as you transition to ICD-10.

About Dana Deardorff of MediPro
MediPro is a full-service medical billing software company offering practice management (PM) software, electronic health records (EHR) and electronic medical records (EMR) from McKesson and IMS.

Since 1995, MediPro, Inc. has been a nationally recognized, award-winning medical billing software company offering practice management systems and electronic health record solutions. MediPro’s mission is to deliver and support integrated solutions to the healthcare community. MediPro recognizes the need for a comprehensive, interactive and cost-effective suite of applications that are customized to address the specific needs of healthcare offices.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.