HIMSS Launches Interactive ICD-10 Transition Guide

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HIMSS has launched the ICD-10 Transition Step-by-Step Guide, an interactive tool aimed at assisting healthcare providers who have not completed the transition to the ICD-10 code set for submitting claims to the Centers for Medicare and Medicaid Services (CMS) and other payers.

CMS set an October 1 deadline for ICD-10 implementation. Claims submitted after this date with ICD-9 codes will not be reimbursed, having a potentially adverse impact on provider cash flow. Developed by the HIMSS ICD-10 Task Force and incorporated into the HIMSS ICD-10 Playbook, the guide assists providers that don’t have ICD-10 in place, or who have ICD-10 in place but are still having difficulty receiving reimbursements.

“While we expect most providers to be ready by October 1, many have pushed conversion to ICD-10 right up to the deadline,” task force chair Dr. Bonnie Sunday said prior to the deadline. “The guide will guide them to quick and practical solutions if problems occur.”

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The guide displays three possible scenarios for providers: A) Need Assistance Processing ICD-10 Claims, B) ICD-10 Claims Sent to Payers, but Not Receiving Reimbursement and C) Claim Files Processed by Payer, but Reimbursement Amounts Not Matching Previous Amounts for Similar Procedures.

Once a provider identifies a scenario, the guide walks the user through short- and long-term solution options, with links to relevant content and resources. For providers with ICD-10 systems in place, there is a walkthrough for the testing process and for troubleshooting rejected claims or incorrect reimbursements.

The guide complements other resources contained in the HIMSS ICD-10 Playbook, such as the Post October 1, 2015 and Contingency Planning sections. Over the next several weeks, HIMSS plans to communicate timely information about challenges organizations are experiencing with the ICD-10 transition, along with suggested mitigation strategies or resolutions, through HIMSS Business Edge newsletter articles, website content and blog posts.

HIMSS is a nonprofit organization focused on information technology (IT) in healthcare. For more information, visit himss.org

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Photo courtesy of: HIMSS

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