AAO urges ICD-10 preparation

San Francisco-With the first trial of the new International Classification of Disease (ICD)-10 medical billing system this month, the American Academy of Ophthalmology (AAO) is urging ophthalmologists to initiate their preparation and training for the switch to the new coding system well ahead of the October mandate.

The ICD-10 is replacing the ICD-9 codes created by the World Health Organization in 1979. In addition to the Affordable Care Act, the switch this year to ICD-10 represents one the most significant changes to affect the American health-care system in decades, according to the AAO.

The new codes will be longer, and the number will jump from roughly 14,000 ICD-9 codes to nearly 70,00 ICD-10 codes, requiring health-care providers to learn thousands of new codes rapidly.

ICD-10 testing-which takes place this week-will serve as one of the first technical tests of the new codes by registered providers and claims processing vendors.

Without proper training and preparation, physicians-as well as hospitals and other health-care providers-face loss of reimbursement due to denied claims, the AAO stated.

The AAO offered the following checklist to help practices prepare for the implementation:

·      Transition planning

o   Identify an ICD-10 coordinator.

o   Identify all vendors, systems, and staff affected by the change.

o   Identify all forms and practice templates that need to be updated.

o   Estimate a budget, including costs associated with software and education.

·      Get your system ready: Vendors/partner readiness

o   Communicate with your vendor and upgrade to the version that supports the new coding system.

o   Confirm vendors have uploaded ICD-10-CM codes.

o   Confirm that system vendors, clearinghouses, and/or billing services will support changes to the new code system.

o   Query your most frequent commercial insurance payers regarding their timing or testing.

·      Paper charts or electronic health records readiness

o   Work with vendors to upgrade your claims submission system to support new CMS 1500 form and electronic data interchange format.

o   Participate in ICD-10 test week.

o   Run diagnosis–productivity report by physician.

o   Convert most frequently reported codes to the new coding system.

·      Process and document readiness

o   Order CMS 1500 forms, mandated for April 1 implementation.

o   Request and review insurance policies and prior authorization requirements with new coding.

o   Develop superbills or charge sheets.

o   Update all templates and other forms that previously used/followed ICD-9 codes.

“Many ophthalmic practices are proactively training and preparing for ICD-10 well in advance of the October deadline as it is time-consuming and for some, an overwhelming process,” said Sue Vicchrilli, coding executive for the AAO. “The Academy is uniquely positioned to provide them with the most comprehensive coding education and resources available for the profession of ophthalmology.

“Our goal is to ensure that practices can appropriately maximize reimbursement by submitting claims correctly-the first time-and audit-proofing their documentation,” she added.

For more ICD-10 training and resources available through the Academy, visit www.aao.org/icd10.

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