For services provided on and after October 1, 2015, U.S.-based entities covered under the Health Insurance Portability and Accountability Act (HIPAA) are required to use ICD-10 code sets. ICD-9 codes will no longer be accepted on claims for services provided on or after October 1, 2015.

FACT: ICD-10 will have a substantial impact on you and your practice.

Medicare fee-for-service end-to-end testing in January/February and in April/May showed claims acceptance rates of only 81% and 88% respectively. The results of end-to-end testing conducted in July have not yet been released by CMS. Beginning October 1, 2015, you should be prepared for the possibility of your claims being rejected by your Medicare Administrative Contractor and by private insurance carriers; thus, you should prepare for substantial delays in reimbursement. CMS warns practices that do not prepare for ICD-10 risk disruptions in cash flow. CMS further advises all practices to build cash reserves and finalize plans with financial institutions to establish or increase lines of credit.

ISASS has been informed by some of our members and partners that accountants are advising practices to build cash reserves of four to six months of operating expenses in advance of the transition to ICD-10 on October 1, 2015. For our membership, this information may be coming a day late and a dollar short. In addition, we have learned that some financial institutions are preparing collections strategies in anticipation of the worst-case scenario that some practices may fold to financial pressures and cash shortages over the next year.

FACT: The situation is serious, but you can mitigate some of these impacts by developing an action plan and preparing your practice now.

You still have time to prepare for the transition to ICD-10; there are a number of resources available to you and your staff. ISASS is currently compiling an information packet specific to spine practices which will be shared with you in the coming weeks. Be on the lookout for another email from us which will include a general step-by-step guide to preparing your practice for ICD-10, crosswalks of commonly used spine codes, and information on where to find additional resources.

In the mean time, you can begin to develop an action plan for your practice and locate additional resources at: 

Roadto10.org →

Additionally, mark your calendar for a National Provider Call on ICD-10 hosted by CMS on Thursday, August 27 from 2:30-4:00 p.m. ET. You can register for the call titled “Countdown to ICD-10”at the following link:

Countdown to ICD-10 →