The long expected news of a delay to the implementation date for ICD-10 became a little more official this week. HHS has formally announced a proposed rule change that would effectively slip the effective date from Oct. 1, 2013 to Oct 1, 2014.
ICD-10 promises to improve electronic communication by adding specificity to both diagnosis codes and CPT codes. The codes are fundamentally 
different because they carry within the code additional information that characterizes anatomic site, severity and other clinical detail. This example provided by the AMA shows both the power and complexity of the new set of codes.
ICD-10 in action for diagnosis codes:
- S52 Fracture of forearm
- S52.5 Fracture of lower end of radius
- S52.52 Torus fracture of lower end of radius
- S52.521 Torus fracture of lower end of right radius
- S52.521A Torus fracture of lower end of right radius, initial encounter for closed fracture
The result is that diagnosis codes grow from 13,000 to 68,000, while CPT codes grow from 11,000 to 87,000. Anyone can see the concern major institutions have about hitting any deadline regarding this change. In fact, there is mounting pressure on HHS to consider waiting for visibility to ICD-11 in 2015 before driving compliance, but that is another blog post in itself.
For Clinicient, buried in the slew of releases from the government was movement on a long-desired proposal. HHS has proposed the establishment of a health plan identifier (HPID). Similar to the NPI, an HPID would make unique ID’s for health insurance plans. As a company that helps its clients submit claims to over 2500 health insurance plans, we have made it our business to create a payer database loaded with plan names and critical settings and payer rules so that connecting to a payer is as painless as possible. What a boon it would be for the payers to submit to having a standard ID so we all agree which payers and plans we are talking about.
For more information on how you can access the power of our payer database with our physical therapy EMR and billing system, contact us.
