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Frequently Asked Questions
Click here for Florida Blue specific ICD-10 readiness FAQs.
- What happens if I do not switch to ICD-10?
Providers can begin to prepare by taking the following steps NOW:
- Talk with your billing service, clearinghouse, or practice management software vendor NOW
- Identify ICD-9 (and presumably ICD-10) touch points in your systems and business processes
- Identify needs and resources, such as training, printing, etc.
- An ICD-10 transition plan should take into account specific practice or organization needs, vendor readiness, and staff knowledge and training.
- Providers should check with their billing service, clearinghouse, or practice management software vendor about their readiness plans.
- Providers who handle billing and software development internally, should plan for medical records/coding, clinical, IT, and finance staff to coordinate on ICD-10 transition efforts.
- Work together to make sure you’ll have what you need to be ready. A successful transition to ICD-10 will be vital to transforming our nation’s health care system and essential to maintaining business operations.
- CMS has resources to help providers prepare for a smooth transition to ICD-10. Visit www.cms.gov/ICD10 to find out more. CMS will continue to add new tools and information to the site through the course of the transition.
- Where can I find your latest ICD-10 Provider Pulse Survey Results?
Results to our 2013 ICD-10 Provider Pulse Survey are available in the Jan. 17, 2014 Open Line Friday provider teleconference presentation (here).
- When is the ICD-10 compliance date?
Oct. 1, 2015.
- If I transition early to ICD-10, will CMS be able to process my claims?
The transition to ICD-10 is a major undertaking for providers, payers, and vendors. It will drive business and systems changes throughout the health care industry, from large national health plans to small provider offices, laboratories, medical testing centers, hospitals, and more. Plans need to devote staff time and financial resources to transition activities. The transition will go much more smoothly for organizations that plan ahead and prepare now. A successful transition to ICD-10 will be vital to transforming our nation's health care system and ensuring uninterrupted operations.
- Who is affected by the transition to ICD-10? If I don't deal with Medicare claims, will I have to transition?
Everyone covered by the Health Insurance Portability and Accountability Act (HIPAA) must transition to ICD-10 according to the latest compliance date, including providers and payers who do not deal with Medicare claims.
- What type of training will providers and staff need for the ICD-10 transition?
Training should take place by early 2015 for most staff. Training needs will vary for different organizations. For example, physician practice coders will need to learn ICD-10 diagnosis coding only, while hospital coders will need to learn both ICD-10 diagnosis and ICD-10 inpatient procedure coding.
Look for specialty-specific ICD-10 training offered by societies and other professional organizations. Take into account that ICD-10 coding training will be integrated into the continuing education units (CEUs) that certified coders must take to maintain their credentials.
Medscape Education modules offer guidance for small practices making the transition to ICD-10. Continuing medical education (CME) and continuing education (CE) credits are available to physicians and nurses who complete the learning modules, but anyone can take them and receive a certificate of completion.
ICD-10: A Roadmap for Small Clinical Practices
ICD-10: Small Practice Guide to a Smooth Transition
Transition to ICD-10: Getting Started
ICD-10 resources and training materials will be available through CMS, professional associations,
societies and software/system vendors. Visit www.cms.gov/ICD10 to access the latest
Information on training opportunities as well as the Medscape Modules above.
- What should software vendors, clearinghouses, and third-party billing services be doing to prepare for the transition to ICD-10?
Software vendors, clearinghouses, and third-party billing services should collaborate with their customers now to prepare them to minimize any business/financial disruption. Ask customers about their needs and establish a comprehensive approach that will deliver compatible products in time for ICD-10. CMS has resources available to help vendors with the transition to ICD-10.
Talking to Your Customers About ICD-10: Tips for Software Vendors
- What do vendors need to know to conduct ICD-10 testing with providers and payers?
CMS has testing resources to help vendors conduct ICD-10 testing with providers and payers. To learn more, visit the CMS end-to-end testing website. If you are interested in testing with Florida Blue, click here.
- How should I start the ICD-10 transition conversation with my payers, software vendors, clearinghouses, and billing services?
CMS has many resources to assist you in communicating with your payers, vendors, etc.
- Talking to Your Vendors About ICD-10: Tips for Medical Practices
- Communicating with Your Payers About ICD-10
- Communicating with Your Software Vendor
- Questions to Ask Your Systems Vendors about ICD-10
- Visit www.cms.gov/ICD10 to find out more.
Providers can begin to prepare by taking the following steps now:
- Talk with your billing service, clearinghouse, practice management or EMR systems software vendor now.
- Identify ICD-9 (and presumably ICD-10) touch points in your systems and business processes.
- Identify needs and resources, such as training, printing, etc.
An ICD-10 transition plan should take into account specific practice or organization needs, vendor readiness, and staff knowledge and training. Providers should check with their billing service, clearinghouse, or practice management software vendor about their readiness plans. Providers who handle billing and software development internally should plan for medical records/coding, clinical, IT, and finance staff to coordinate ICD-10 transition efforts. CMS has many resources, including those below, to help providers prepare for a smooth transition to ICD-10.
- Role of Clearinghouses in the ICD-10 Transition
- Plan to Mitigate Risk for a Smooth Transition
- Planning Your ICD-10 Transition Activities for 2013
- Simple Steps to Improve Clinical Documentation
- Develop Your ICD-10 Communication and Awareness Plan
- The ICD-10 Planning Checklist
- Review How You Use ICD-9 Codes
- Looking Back at Version 5010 and Ahead to ICD-10
Visit www.cms.gov/ICD10 to find out more
FB PRV COMP 005 NF 082015