Insurance carriers often deny claims for not being coded to the highest level of specificity or they may consider the diagnosis truncated. As many billers are not coders, they often don’t understand what has gone wrong or how to fix it.
What is the highest level of specificity?
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The impending transition from ICD-9 to ICD-10 diagnostic coding sets has healthcare providers concerned over the confusion that may result when they switch from roughly 18,000 codes to nearly 150,000.
The Centers for Medicare & Medicaid Services (CMS) is attempting to alleviate some of the anxiety for the October 2013 deadline by publishing a guide to implementing ICD-10.
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Time is running out for medical providers to update to the new HIPAA Version 5010 financial system software and International Classification of Diseases 10th Edition (ICD-10). The first step in the process is the Version 5010 data-transmission standards upgrade, which the majority of practices are unprepared for.
According to a recent member survey by the Medical Group Management Association (MGMA), only one in 50 practices have completed the 5010 implementation.
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Question: Our senior partner wants us to stop using Social Security numbers as patient identifiers immediately. Furthermore, he wants them removed from charts as charts are handled. We do not require patients to disclose this information if they choose not to. Medicare uses the SS# as the patient identifier, Ohio Workers’ Comp uses SS#, and our PMS system uses it as well.
We have multiple patients with the same dates of birth and, interestingly, a handful of patients with the same names AND date of birth! We will be migrating to a new PMS/EMR in several months and I had hoped to make this change at that time.
If not the SS#, what data are you using as the patient identifier?
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As the date to switch to the ICD-10 diagnostic coding system gets closer, medical practices have one question: How much is implementation going to cost?
Nachimson Advisors, LLC was retained by several healthcare organizations to answer that very question. After crunching the numbers, the final cost of implementing ICD-10 appears unsettling.
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