Iron out potential challenges with ICD-10 billing services


As you prepare for inclusion of ICD-10 codes on claims for services provided on or after Oct. 1, 2014, make sure your plans won't be delayed or derailed by third-party billing services. The Centers for Medicare & Medicaid Services (CMS) recommends that you reach out to clearinghouses or billing services now to iron out any potential difficulties.

CMS provided the following set of questions you may want to pose to clearinghouses or billing services:

  • Are you prepared to meet the ICD-10 deadline of Oct. 1, 2014? Where is your organization in the transition process?
  • Can you verify that you have update your system to Version 5010 standards for electronic transactions? (Only systems with Version 5010 can accept ICD-10 codes; systems with the older Version 4010 standards cannot accommodate ICD-10.)
  • Who will be my primary contact at your organization for the ICD-10 transition?
  • Can we set up regular check-in meetings to keep progress on track?
  • What are your plans for testing claims containing ICD-10 codes? How will you involve your clients, such as my practice, in that process?
  • Can my practice send test claims with ICD-10 codes to see if they are accepted? If so, when will you begin accepting test claims?
  • Can you provide guidance or training on how my clinical documentation will have to change to support ICD-10 coding?
  • Do you anticipate any pricing changes for your services due to the switch to ICD-10?

CMS noted that if you do not currently use a clearinghouse or billing service, you should consider enlisting one to help you with your transition. Ask other providers in your area if they have established relationships or contacts that they would recommend. Be sure to allow yourself enough time to select the service that best meets your needs and budget.

For additional CMS resources on making the transition, click here to visit the agency's ICD-10 website.