Submitted on Mon, 2015-10-26
By SMART Health Claims

Renewed Focus on Patient Care as ICD-10 Roll Out is Met with Few Issues

The medical community breathed a collective sigh of relief following the October 1st ICD-10 transition. Early feedback indicates that the roll out went very smoothly, deflating predictions that the transition would be burdensome on private and public health practices.

The relief stems from widespread trepidation within the medical community leading up to the deadline. The magnitude of this transition was daunting, moving to a new billing code set with more than 140,000 ways to describe diseases and medical procedures. Yet, much like the build-up surrounding Y2K, ICD-1O anticipation proved more stirring than the actual result. 

Public health agencies were pleasantly surprised by the smooth transition. While initially overwhelmed by the volume of new codes, local health departments and community health centers found the number of actual public health-specific codes, such as those for vaccinations, were very manageable.

“Despite all of the potential for errors, we are seeing a very successful transition to ICD-10 for local and community health agencies,” said Nar Ramkissoon, MPH, Director of Payer and Provider Initiatives, Upp Technology. “We were confident that this would be a smooth transition because of how hard everyone worked to prepare. The top priority throughout this entire process was to ensure this transition did not affect reimbursement for services provided to patients.”

A Renewed Focus on Patient Care

Overall, the impact of the transition was very positive as the entire medical community banded together and demonstrated a renewed focus on patient care. Healthcare providers made sure that essential resources were in place so patient care was unaffected, and Healthcare Payers were gracious in their acceptance of slightly inaccurate ICD-10 claims. Large insurance companies, including Aetna, Humana and Cigna, indicated that they are paying claims as long as the code is in the proper family of ICD-10 codes, following the lead of Medicare & Medicaid. Humana also reported that ICD-10 calls in the first week amounted to“only 0.03 % of all calls from providers regarding benefits, claim status, spanning date of service, and authorization.”

As with any transition, there are still wrinkles that need to be ironed out. Forbes reported that small doctor practices in states including California, Louisiana, Maryland and Montana, are still unprepared for the ICD-10 transition. In those states, Medicaid is going to match claims to an ICD-9 code, a term called “crosswalking,” to alleviate issues.

ICD-10 Claims are Getting Paid

While acknowledging the leniency provided by payers in light of the massive transition, ICD-10 claims are now moving through the system and getting paid.

The rate of rejected ICD-10 claims is almost identical to ICD-9 rates.

A Shared Mission of Better Patient Care

After all of the build-up about ICD-10, billing processes went fairly uninterrupted in both private and public health environments. For LHDs and the entire medical community, the transition will pay off in dividends as America’s communities get better, more accurate care and treatment. 

From private to public and providers to payers, the transition seemed to inspire the best possible result – a renewed focus on providing the best patient care possible.


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