October 1 is fast approaching, and that means it’s nearly time for ICD-10 implementation. Hopefully your staff is trained and prepared to use the new codes in all of their updated and more descriptive glory. While you might be clear on the deadline and what you need to do to prepare for it, the idea of dual code submission might not be as crystalline. Here’s the lowdown:
First, you can’t submit both ICD-9 and ICD-10 codes on the same claim. Not happening. So, which code set should you use? That depends on the claim’s date of service—not the date of submission. That means any claims submitted for dates of service before October 1 should contain ICD-9 codes. And the ones with dates of service on or after October 1? You guessed it: Those claims should contain ICD-10 codes. This is something you will need to monitor closely in your clinic. In the event that you do end up submitting a claim containing both ICD-9 and ICD-10 codes, you must split the claim. (Just be sure to ask your payers about their splitting specifications first.) So, even though ditching ICD-9 altogether—at least at first—isn’t feasible, it doesn’t mean you need to be stuck in dual coding limbo.
You probably don’t want this dual coding period to continue on for too long—and luckily for you, there are some steps you can take to shorten the process. Start by examining how quickly you’re preparing claims; then, adjust your processes to accommodate those timelines. Or, set goals to get the claims out even more quickly. Ideally, you should submit all claims within 24 hours of the date of service. This will help speed up the process of denial management. Another way to shorten your dual coding time is to figure out how long a typical claim is open. Once you have a rough idea of how long it takes for both ICD-9 and ICD-10 codes to process (again, not on the same claim), you’ll be able to account for any additional processing time.
If you already have solutions in place to help you transition to ICD-10, that’s great. If not, you should start looking for some software solutions—sooner, rather than later. If you do already have systems in place, then—in addition to examining your own processes—you’ll want to ask your EMR system, third-party vendors, billing services, and clearinghouses if they can handle both ICD-9 and ICD-10 codes. Ideally, all of your vendors will have already taken this transitional period into consideration.
The nitty-gritty details of the transition to ICD-10—including dual coding—might seem a bit muddy. However, with some preparation, it doesn’t have to be a big mess. Are you ready to handle coding for both ICD-9 and ICD-10? Share your thoughts in the comments section below.