Lessons from CMS: The ICD-10 Readiness Checklist

By now, every provider, insurance company, coder, and biller knows that Oct. 1, 2015 is when ICD-10 comes into effect. The Countdown to ICD-10 was recently hosted by CMS and featuring significant industry organizations providing advice on how to prepare for the transition.

First and probably most importantly for physicians, the organizations noted Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes will still be utilized for the physician portion of the billing process. Second, ICD-10-CM will be utilized by all providers in all healthcare settings, while ICD-10-PCS is utilized solely for in-patient hospital procedures.

Building on these two core concepts, what follows is a checklist that can be utilized by physicians and other medical professionals to help ensure that all preparations are in place.

While many of these steps should have been implemented, taking the time to go through this checklist can reduce the anxiety of transitioning to ICD-10, work out any “glitches” with EHR systems and CMS/claims clearinghouses, and reduce the risk of rejected claims. As always, it is crucial to document that the service or procedure was medically necessary.

Helpful links:

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1408.pdf

https://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10QuickStartGuide20150622.pdf

Printable version of the checklist: http://imaging.ubmmedica.com/all/editorial/physicianspractice/pdfs/ICD10_checklist.pdf