Friday, November 1, 2013

Changes to Medical Billing and Coding Requirements

Big changes are coming to the world of medical billing and coding. The introduction of Electronic Medical Record and the 10th edition of the International Classification of Diseases, Clinical Modification and Procedure Coding System (ICD-10) are creating a flurry of activity to ensure a smooth transition. These new developments will affect all medical practitioners’ medical billing and coding and submission of claims. The developers of ICD-10 claim that the new code sets will provide more accuracy in medical coding, which will result in quicker reimbursements and fewer denials.  This will result in better patient care all around.

By October 2014 all ICD-9 code sets used to report medical diagnoses and inpatient procedures must be replaced with ICD-10 code sets. This means that all electronic transactions must use Version 5010 standards to accommodate the ICD-10 codes. Previous versions, Version 4010 and Version 4010 A standards will not accommodate the ICD-10 codes. This should not be a problem for the majority of medical billers because Version 5010 has been required since January 1, 2012.

It is important to note that any claim with ICD-9 codes for services provided on or after the compliance deadline cannot be paid.

The Basics of Preparation

It is important to take several steps before the deadline to make sure the medical billing and coding for each practitioner is up to date. All practitioners that are covered by the Health Insurance Portability Accountability Act are required to transition to ICD-10 code sets.

The software used for EMR and medical billing should be upgraded to a version that incorporates ICD-10. In some cases, hardware upgrades will be necessary. Reaching out to software vendors is an important part of the implementation plan. Ideally the software will be updated and installed with enough time to test it before the compliance deadline.

This is the first in a series of blogs explaining the ICD-10 requirements and ways to have a seamless implementation.

1 comment:

  1. Already a big changes are started in medical billing billing and coding requirements. Professional medical billing services are developing day by day in the healthcare field because of their most wanted services. with in 2 to 3 years it will become one of the best business in medical business