Mr. McDonald began his presentation by noting the difference between ICD-9 and ICD-10, which is really a substantial one: There are 14,432 codes in ICD-9, but 69,368 in ICD-10. Mr. McDonald also said it looks like the latest go-live date for ICD-10 seems to be CMS’ final one. “We know the date’s been pushed once from Oct. 1, 2013 to Oct. 1, 2014, and it looks like they’re very serious about keeping it where it is at this point,” he said. “I would not go through this year thinking it will be pushed again.”
When Mr. McDonald asked attendees to name one benefit of ICD-10 to surgery centers, the room grew quiet. “It’s very difficult to find [something] that actually benefits you as an ASC,” he said. “There are many benefits to the government and payers, but few to ASCs.”
ICD-10 will have a great impact on ASCs’ day-to-day operations and business functions. This includes:
• Scheduling
• Coding and billing, including search options and claim form changes
• Reports that include the diagnosis code
• State reports that include claim data elements (these changes will vary by state agency)
• Interfaces, custom reports and custom forms
• American Medical Association code imports
• Physician documentation, as studies have shown less than 50 percent of current documentation by a physician will be adequate under ICD-10
Mr. McDonald recommended that every ASC develop an ICD-10 steering committee, regardless of the center’s size, to drive the team’s transition. He also encouraged administrators to contact their vendors, who can send additional information and FAQs about ICD-10. “Make sure your vendor is planning ahead, so that you’re not still waiting for software on Sept. 15,” he said. “That can’t happen with ICD-10. We need to be ahead or we’ll be in trouble.”
ASC administrators should also consider ICD-10’s potential impact on their reimbursement. “This is a great time for insurance companies to deny your claims, and they will” said Mr. McDonald. “Expect it. If you’re [with] a facility with tight budgets, I’d begin saving for a cash reserve today.”
Mr. McDonald concluded the presentation by urging ASC administrators to not rest on their laurels. “My fear is a lot of us are putting this off,” he said. “A lot of people think CMS will push the date. We see signs when CMS will push a date, and we don’t see it this time.”
More Articles on ICD-10:
5 Steps to Prepare for ICD-10 Starting Now
7 Ways to Make the ICD-10 Switch Less Painful
CMS Seeks Input on ICD-10 Testing, Key Concepts
