By ROB Editors
August 12, 2015
Excerpted from the newly published 2015 version of Vision Source’s Navigation Guide to Health Care Reform for Independent Optometrists.
ICD-10 is less than 50 days away. Here are 5 steps to ICD-10 success.
The new ICD-10 codes–which go into effect October 1, 2015, are considerably more complex than the ICD-9 set, with 68,000 codes compared to 13,000 ICD-9 codes, adding additional specificity on disease diagnosis, severity and treatment stages. A major change is that the ICD-10 codes require a practitioner to specify the laterality or bi-laterality of a condition, as appropriate. Under ICD-9, the coder was supposed to specifify laterality or bilaterality using modifiers, so the only new thing here is that laterality or bilaterality is a part of the base code instead of needing a modifier. Each ICD 10 code has three to seven characters in the following sequence:
• Category (letter)
• Etiology (number)
• Anatomic site (letter or number)
• Severity (letter or number)
• Extender (letter or number)
1. Confirm that your practice management software system has been, or will be, updated to support the new codes. Make sure the third parties you work with will accept your software sending ofthe new codes. Do a trial run.
2. Train doctor and staff on the structure of the new coding system and differences from the ICD-9 structure.
3. Review documentation from Medicare and major insurers on the conversion, administrative procedures and compliance standards.
4. Establish a process for how ICD-10 codes will be selected (manual, look-up program).
5. Practice ICD-10 code selection as soon as possible.
6. Take your top 20 codes used in 2014 and convert them to ICD-10, then create a “fee ticket” (“superfee slip”), so the only codes you have to look up are the unusual ones.
Includes Codes for Optometry, a resource that provides tools to help ODs transition from ICD-9-CM to ICD-10-CM. It clarifies the new diagnosis codes in detail to assist in making correct ICD-10-CM coding choices.
This coding bundle includes three guides approved and recommended by AOA’s coding experts: 2015 AOA Codes for Optometry (ICD-10), 2015 ICD-10 CM AOA Express Mapping Card (not sold separately) and 2015 AMA CPT Professional Edition.
The Centers for Medicare & Medicaid Services (CMS) announced that it is working with the American Medical Association (AMA) to ease the transition.
ROB Professional Editors Mark Wright, OD, FCOVD, and By Carole Burns, OD, FCOVD, offer a three-step process for readying staff for ICD-10.