News Alert: ICD-10, HIPAA 5010, New DHCS’ Fiscal Intermediary
ICD-10, HIPAA 5010, New DHCS’ Fiscal Intermediary...
Ladies and Gentlemen Brace Yourselves, We are Entering an Eye of a Hurricane...
You have gone to seminars and conferences on the subject, your staff has been trained, your IT department is probably still scrambling to get your facility’s software ICD-10 and HIPPA 5010 compliant... You are a seasoned veteran of health care administration battles – you’ve weathered the previous (2003) HIPAA transition, the switch from the UB-92 to UB-04, from EDS to HP, from Legacies to NPIs, NDC’s... During these few months before the transition and even a few months into it, a strange and ominous calm will likely overtake you - just before you get hit with first wave of denials.
It is the rare convergence of several dramatic changes that will likely make the transition much harder and, for a health care administrator, more challenging to track the various currents threatening to carry hospital revenues away. As we receive feedback from hospitals regarding the various problems they will be facing, we will share them here whenever possible.
It is just too easy for media to poke fun at the ICD-10 coding burns from water skis on fire or listing three separate codes for “walked into a lamp post” or, for tracking accidents in opera houses, but the sheer enormity of the change should give everyone a pause – we are switching from an 18,000 code system to 140,000, which means that doctors, coders and hospital computer systems will need to be aware of and process eight times as many codes.
Nobody can predict how many claim denials and disputes will arise from the upcoming changes. For now, your main remedy is vigilance and preparedness. During the first few months of transition first problems will start emerging. Make sure your staff is alert and picks up on new denial trends so you can swiftly address them and not allow payors to profit from the confusion which unfortunately, is likely to ensue – another shoe in the mix – MediCal announced continued use of 4010 through 2012.