Transitioning to ICD-10
Join us for a transitioning to ICD-10 webinar as we recommend tips and tricks for preparing you practice to tackle ICD-10.
March 6th, 2014 from 1:00- 2:00 pm EST. Register here
Who will be affected by this change?
Everyone covered by HIPAA will be required to use ICD-10 on and after the effective date. Claims that do not use ICD-10 after October 1st 2014 will not be processed. Do note, however, that claims for services provided prior to October 1st 2014, must use ICD-9 codes.
Will we have to use both ICD-9 and ICD-10 during transition?
Yes. Until all claims for services before the effective date have been processed and completed, practices must be able to accommodate both coding systems. There are also a number of payers (e.g. Medicaid) who were granted exclusions/extensions and will continue using ICD-9 codes after the effective date.
How long of a grace period will be given?
There is no grace period. It has been made abundantly clear that absolutely no extra time will be provided to implement this new system. The effective date (October 1st, 2014) is the FINAL date to implement ICD-10.
Why the change?
There are several reasons our health care industry is making this transition. First, ICD-9 is 30 years old. Because of this as well as advances in the medical field, many terms are now outdated. Therefore the design only allows for a limited amount of new codes to be added, thus many categories are now full. Also, ICD-10 will facilitate a much more accurate and efficient billing process, increase quality initiatives, as well as allow for greater precision and specification in Doctor’s diagnosis.
How soon should we start training?
This varies depending on the size of the organization but it is generally recommended to begin your training no more than 6 to 9 months before the date of transition. Training is expected to take roughly 16 hours for outpatient coders and 50 hours for inpatient coders. There is also a need to train physicians and the clinical staff. This will roughly follow the same methodology for both timeline and hours.
Questions Regarding gMed Prep and Implementation
What is gMed’s ICD-10 readiness plan?
gMed has partnered with a third party medical content provider, Health Language, used by many major EHR vendors for ICD-10 and other clinical content. This vendor delivers a comprehensive library of commonly used synonyms with mappings to ICD-9, ICD-10 and SNOMED. It is fully integrated within gGastro and provides a smooth integration of ICD-10 codes into the existing workflow.
gMed’s upcoming release version 4.53, scheduled for general availability in March 2014 includes ICD-10 support for the office visit workflow. You can code patient conditions and diagnoses using ICD-10, send the ICD-10 codes via interface to your Practice Management system, or post the codes to the gPM superbill automatically. Successful tests of exchanging the data with a number of Practice Management systems, as well as with our Clearinghouse have been performed.
gMed’s next scheduled release version 4.54, target date July 2014, will complete the ICD-10 support for automated procedural coding.
Does gGastro require a software upgrade to be ICD-10 compliant?
What version of gGastro is compliant with ICD-10?
Version 4.53 or later.
When will gGastro be ready for ICD-10 internal testing?
Does gGastro require a hardware or storage upgrade to be ICD-10 compliant?
No. You will not need a hardware or storage upgrade in order to implement the new ICD-10 system.
What is the estimated system downtime during upgrade installation?
The duration of the upgrade will last anywhere between 1-4 hours.
When can my practice be added to the queue to have the upgrades installed?
As of March 2014 you can start contacting our support team to schedule your upgrades.
How will ICD-10 affect the workflow in gGastro?
We have made every effort to integrate ICD-10 into the application with minimal disruption to your workflow. The major impact to your workflow will simply be the thought process that will be involved in determining more specific codes for patient conditions, and performing more detailed documentation of the patient’s condition in order to properly reflect and support the coding. However, you will follow through exactly the same workflows/steps for the documentation of new diagnoses. Simply, your selection from a search result will now have 3 codes instead of just one.
When dealing with an existing diagnosis, you will have to take an extra step to select the appropriate ICD-10 code. Wherever a 1:1 matching is possible, gGastro will automatically insert the ICD-10 code on the diagnoses during the upgrade. However, there are many diagnoses that require clinical decision making based on the patient’s condition to select the appropriate code.
How much longer will it take to code a superbill in ICD-10 compared to ICD-9?
For our gPM users, the ICD-10 codes flow over from the services directly into the Superbill. So you will not need to perform any additional steps on the superbill. For documentation of a superbill for non-gGastro services you will search for a diagnosis and make the selection of the appropriate item. The trilingual search will present you with the best match to the clinical term you need to code.
How many added steps will there be to select the correct code?
None. You will perform the keyword search exactly as you would with ICD-9. We recommend that you use more keywords so that your search results are more refined (e.g. searching by Hemorrhoids will result in several ICD-10 search results, searching by Hemorrhoids grade 1 will bring a single search result). Our new search provides an auto-suggest feature so while you type it will list the common matching terms to facilitate your search.
How do you prevent invalid or clinically inaccurate ICD codes?
Our database is continuously updated to remove expired, outdated or deleted codes. Provided that you use the accurate keywords to define the patient’s condition, the search results will present you with accurate relevant codes.
Will gGastro or existing reports require any special or custom developed edits?
Yes, but only if you have implemented custom reports or applications.
Will my practice be provided the option of participating in testing?
Yes, should your practice be interested, gMed will setup a test environment for users to test the application via the internet.
Will gMed support dual coding of ICD-9 and ICD-10 during the transition period?
Yes, all diagnoses can be coded with ICD-9 and ICD-10 codes. The ICD-9 code support may have to last past the compliance date since some payers will not
Will gGastro support crosswalks?
Yes. A cross walk is provided for ICD-9, ICD-10 and SNOMED codes to assist with ICD-10 compliance as well as Meaningful Use compliance.
Will training be required to use ICD-10?
Yes, training will be absolutely imperative in order to successfully make the transition to ICD-10. gMed will be publishing several educational videos and documentation on the gBUS site for training purposes. However, proper ICD-10 training for your physicians and coders should be scheduled via Medical Coding organizations.
Will there be additional fees for ICD-10?
Yes, this is a pass-through cost from the third party vendor involved in the medical content provision and intelligent code search and mapping capabilities. The additional yearly cost of $100 per provider or per endo room (for ASC-only clients) will be billed as a yearly subscription fee. For gGastro Cloud subscribers the fees are included as part of the subscription cost.
Will gMed be able to include ICD-10 in DFT (billing) messages sent to our Practice Management system from gGastro?
Yes, both codes will be included in the interface messages and sent to the PM system to allow the PM to manage the codes accordingly and include the appropriate codes on the claims depending on the date, payer, etc. Successful testing with a number of PM systems has already been performed.
Are you using look-up tables or general equivalence mapping (GEM) solutions in your system for ICD-10, or will your system automatically provide the correct ICD-10 codes with the exam notes?
gGastro provides an intelligent term based and code based trilingual search (ICD-9, ICD-10, SNOMED). Since exact matching between ICD-9 and ICD-10 codes is not always possible, it is strongly recommended that a term based search is used to find the most appropriate code based on the actual condition specifics of a given patient.
For Procedural documentation, gGastro will also provide automated intelligent coding for GI specific findings.
Using GEMs as a sole basis for conversion is often incomplete or unsuited to the individual needs of a specific healthcare organization. Transition efforts based exclusively on the GEMs may not produce optimal results. The third party vendor content set extends the GEMs and adds ICD-9 – ICD-10 diagnosis code mappings missing from the original set. Using various attributes clinicians and coders have created additional maps in the forward direction that augment the incomplete GEMs maps related to these attributes. This results in a more comprehensive and clinically correct ICD-9 to ICD-10 translation.
Will gMed participate in the CMS testing week in March?
Yes, gMed will participate in the CMS testing week in March. A sample of 5 test claims per client will be submitted and tracked by Practice Insight for each gPM client.
Is gPM compatible with my clearinghouse?
gMed has successfully tested sending and processing ICD-10 with Practice Insight
Do I need to test ICD-10 with my payer?
Yes. It is recommended that you contact your payer and schedule testing for ICD-10 claims.
How can I test ICD-10 with my payer?
Once you upgrade to gGastro v4.53 you will be able to send ICD-10 claims to your payers. You will need to contact your payer to review payer’s readiness and process to support and test ICD-10 claims.
Does gPM support the new CMS 1500 form?
Yes. gMed has already deployed and tested the new CMS 1500 with a number of gPM users