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Change Is Constant!  Are You Prepared?

Update: April 2014 – The government has passed legislation that includes another temporary SGR fix, as well as a delay to the implementation of ICD-10.  The deadline for ICD-10 is now October 1, 2015.

No one can say that you don’t have to be on your toes to keep up with changes in the field of mental health. 2013’s big changes included new CPT codes and the DSM-V.  This year’s will include ICD-10 and the latest stage of implementation of the Affordable Care Act, also known as Obamacare.

ICD-10

ICD-10 will be replacing ICD-9 this year with the implementation deadline being October 1, 2014. There are two facets of ICD-10, one impacting diagnostic codes and the other impacting CPT codes.  Only the diagnostic codes will impact most mental health professionals as the CPT changes are  only for inpatient hospital codes. The DSM-V already includes the new ICD-10 diagnostic codes, though it’s important to note that they don’t all line up perfectly. They will continue to be updated into the foreseeable future, as the ICD-10 codes are reviewed and can be potentially updated each year. It’s also important to note that only HIPAA Covered Entities are required to use ICD-10. However, anyone dealing with insurance at all, even if only to supply your clients with a Superbill to file claims on their own, is strongly encouraged to make the switch. Since insurance companies will be making the move, you run the risk of claims being rejected if you aren’t providing the ICD-10 diagnostic codes.

What Can You Do To Prepare?

• Check with Vendors – Ensure that any diagnostic and insurance billing software you or your billing representatives are using will be updated on October 1, 2014.  This might be traditional software on your computer, a cloud-based EMR/Practice Management system, or whatever system your billing company uses.
• Familiarize Yourself With the New Codes – Through the DSM-V or the Center for Medicaid & Medicare Services, educate yourself about the new diagnoses and codes.
• Create a Transition Plan – It’s especially important that larger organizations ensure that everyone is trained and that all systems are ready for the transition on October 1.
• Note that the transition takes place on October 1.  You can’t use the new codes prior to that, and use of ICD-9 codes for services provided on or after October 1 will be denied.

Stay tuned to the Tame Your Practice blog, newsletter, and social media for continuing updates on this and other issues throughout the year.