(For Real This Time. As In, Most Likely.)
Did you hear that? That fired up, ready to take off, rumbling sound?
That is CMS revving its ICD-10 engine.
CMS just concluded a week of testing to determine whether it could handle ICD-10 codes submitted to Medicare.
661 participants -- including billing companies, clearinghouses, providers and suppliers -- submitted about 15,000 claims. 81 percent were accepted by CMS—an improvement from the last round of testing and a sign that the industry is almost ready.
What is ICD-10?
ICD-10 is the simplest complexity in healthcare. It’s just a coding system—a really big one.
ICD-10 is the clinical classification system currently being used by the majority of the world. It has more than 68,000 diagnoses codes, compared to ICD-9’s 15,000.
The U.S. is the only industrialized nation not using ICD-10, making it hard for payers to pay claims fairly since ICD-9 does not accurately reflect current technology and medical treatment.
What’s with all the ICD-10 Delays?
ICD-10 has been delayed three times since it was originally proposed in 2005. Much of the industry thought the latest October 1, 2014 deadline would stick, since CMS vociferously reassured physicians as recently as February 2014 that it would not change.
That is, until it changed.
For many physician practices, the 2014 ICD-10 delay was a relief. Most industry watchers believe that large health systems, payers and hospitals were prepared, but physician practices lagged.
Still, the delay took a financial toll on the healthcare industry—costing up to $6.6 billion on lost ICD-10 investments, according to American Health Information Management Association (AHIMA). The potential disruption to the revenue cycle could also have a particularly negative credit impact on for-profit hospitals, according to a recent Fitch Ratings report.
The new October 1, 2015, ICD-10 deadline, however, is likely to stick.
In our next blog post, we will discuss the unique implications that ICD-10 has on PTs.
To learn more about ICD-10, we also recommend joining this week’s webinar: "Demystifying ICD-10". Knowledge is the best weapon!