The transition to ICD-10 in October had been much dreaded by accounting offices across the Medicaid billing field. The launch was delayed by a year, but it looks like that extra time to prepare paid off, as CMS is calling the first month of ICD-10 billing a success.
For the last year (but especially the last few months), our billing team has been helping to guide providers in the transition to the new coding model for their immediate Medicaid billing. For the most part, that conversion of general diagnoses for standard services sufficed, and it was easy enough to translate. CMS is reporting upon initial results that overall since the launch of ICD-10 last month, the percentage of denied claims due invalid codes has been a rather small .09 percent of all rejected claims! Of the nearly 4.6 million claims reported submitted per day on average under the new coding system, approximately 4,100 were denied due to invalid ICD-10 codes, many more denied claims being rejected for incomplete information. Considering the specificity of these codes and that general crosswalks weren’t an option with the sturctural differences, new diagnoses and multiple potential new diagnoses codes to match a corresponding ICD-9 code, this is quite an achievement in our field! T
These new codes should allow for greater reporting, changes in terminology and how injuries are viewed. Many providers spent a lot of time clarifying with physicians just which new diagnoses that very standard prior autism diagnosis in ICD-9 would become in ICD-10. How did that transition process go for your agency, and what did you do to prepare the transition to the new billing codes and rates? Were new diagnoses and clarifications needed at physician visits? Did you address historical injuries and other “history of” diagnoses? CMS anticipates better auditing and reporting with the new detailed data. Does your agency plan any new reporting in relation to the new coding standards?