As your practice is preparing for the impending ICD-10 changes, you might have many questions concerning billing procedures and software requirements. To help you get the answers you need, we have compiled some common questions and answers. Feel free to add any new questions in the comment section below.
Q: I have a question about the top 50 ICD-9 codes we use, and doing the crosswalk to ICD-10. Where is the best resource for being able to do that?
A: CMS GEMS would be one website that you can use; that’s CMS’s GEMS System, which is the General Equivalent System that they use — the General Equivalent Mapping System that they use to translate ICD-9 to ICD-10.
Another good site for you is AAPC.com. Click on their ICD-10 link and they have a feature where you type in our ICD-9 and it returns the equivalent ICD-10 code.
GEMS prompts you to choose the lateralities and origins, whereas AAPC is more one-to-one, but GEMS is really what most systems are basing their crosswalk from, and GEMS is built and maintained by CMS, the CDC, and AMA.
Q: I’ve done all my conversions from ICD-9 to ICD-10 and I’ve done the left and right conversions. We’ve changed some of our documentation so it’s more specific about mechanism of injury — the when, where, the why and the how. What else is there really to do?
A: You really want to make sure that how the practice is supposed to document the guidelines for documentation are clearly outlined in your policies and procedures manual. And that means adding in specificity and laterality. The manual should also have references as to where you seek the information; your reference point would be to CMS.
Q: If I want to take a coding course to get certified, do I need to be certified on ICD-9 and ICD-10?
A: Right now, you have to certify for both, but after October 1, 2015, you only have to certify for ICD-10.
Q: Are you able to come out and help us train our staff?
A: We can give you the tools that you need in order to train your practice. They can also take external classes — specifically from the AAPC, because their classes on physician documentation are extraordinary. In terms of crosswalking, we will work with you.
Q: Where can I find CMS guidelines in written form?
A: On CMS.gov, click on the Medicare link and you will find a link for both local and national coverage determinations.
Q: When can I start finding ICD-10 codes within your software and submitting them?
A: Our software already has all of the ICD-10 codes listed; we are building the crosswalk now. We recently completed ICD-10 testing with Medicare, and were successful with our front-end edits. We are looking to have this available to practices by June, to really start testing and crosswalking. At this point, payers are not accepting claims in ICD-10; they are not coming over until October 1, 2015, but we are testing with payers and clearinghouses directly.
Q: Will you install products well before the October 1, 2015, deadline, so I can begin testing them now?
A: We began crosswalking for ICD-10 in February 2014 and completed the process in April. Speak with your coach about testing for the new coding system.
Q: When will you update my current products and applications for ICD-10?
A: Our products are continuously update in accordance with new regulations and policies, so the ICD-10 changeover will be virtually seamless.
Q: Will there be a charge for these updates?
A: We do not charge for updates.
Q: Will I need new hardware to accommodate ICD-10-related software changes?
A: No. Our software, being cloud-based, will continue to run on your current hardware.
Q: What are the costs associated with maintaining new products?
A: There are no additional costs.