2013 Will Be Here Before You Know It

BALTIMORE — According to presenters on a CMS national
conference call last week, Oct. 1, 2013 — the cutover date
for new ICD-10 codes — will be here before you know it.
“There will be no delay of the implementation period and no grace
period,” said Pat Brooks, senior technical advisor for CMS’
Hospital and Ambulatory Policy Group. “I can assure you that is a
firm implementation date.”

While there are some 14,000 diagnosis codes and 4,000 procedure
codes under the ICD-9 system, there will be 69,000 diagnosis codes
and 72,000 procedure codes under the new ICD-10 classification. But
not to worry, Brooks told listeners: System overseers have
developed General Equivalence Mappings, or GEMS, to assist in
converting data.

As far as preparing for the implementation of Medicare’s
fee-for-service 5010 program, conversion must come sooner. HIPAA
legislation mandates that the health care industry use standard
formats for electronic claims and related transactions. The 5010
program implements new versions of those standards (ASC X12 Version
5010 and NCPDP Version D.0), and it’s a prerequisite for the ICD-10
project.

External testing of the program will begin in 2011, with
mandatory compliance on Jan. 1, 2012. Anyone who is submitting
electronic claims must be changed to the 5010 version — and
that includes HME companies that either send electronic claims or
receive electronic remittances.

CMS’ Christine Stahlecker, director of the Division of Medicare
Billing Procedures, advised providers to get ready now. The new
versions have some different data element requirements that could
require business process changes in order to capture the data, she
said.

To prepare, Stahlecker said providers should make sure their
software upgrade will be completed “well before” the 2012 cutoff,
begin planning for staff training if necessary and evaluate any
impact to routine operations that could be required for the
transition.

Audio and written transcripts of the June 15 call should be
posted on the ICD-10 website within the next few weeks, presenters
said. A follow-up call has been scheduled for Sept. 13.