On October 1, 2015, ICD-10 will go into effect, displacing ICD-9, which has been in place for 30 years. ICD-10 will introduce greater detail and therefore greater complexity to medical billing and coding practices. Indeed, In excess of 150,000 new procedure and diagnosis codes will be introduced. As a result, it is safe to say that disagreements with carriers and controversy in interpretation will be commonplace for some time to come. Because of this, medical providers need to brace themselves for what is sure to be increases in denials from carriers with a concomitant reduction in revenue. Although these denials of course can and should be challenged at every turn, medical provider cash flow in the short run will certainly be impacted.
This is especially true in light of the fact that ICD-10 is not being mandated, thus far, at the state level. Hence, PIP and WC claims can still be processed under ICD-9. This gives PIP and WC carriers perhaps an additional opportunity for denial—they might request a bill submitted under ICD-9 to be re-submitted under ICD-10 and vice versa—anything to cause delay or denial in reimbursement.
Medical providers need to be especially vigilant and aggressive in their refusal to accept these denials and delays at face value, and should prepare themselves financially for a reduction in revenue, at least in the short run.
If you have questions regarding ICD-10, or any other legal questions, please feel free to contact Callagy Law today! If you are a medical provider, please refer to our Medical Providers page on our website.
Learn More About Callagy Law Here:
The Short-Term Impact of the Transition to ICD-10
No comments:
Post a Comment