ICD-10 goes live

Thursday, October 1, 2015

WASHINGTON – ICD-10 went into effect today, but it will be several days, if not a month, before the impact of the new code sets in.

“It will take a couple of weeks before we have the full picture of ICD-10 implementation because very few health care providers file claims on the same day a medical service is given,” said Sean Cavanaugh, CMS deputy administrator and director,in a blog post. “Most providers batch their claims and submit them every few days.”

Once submitted, the claims take several days to be processed. Medicare must then wait two weeks before issuing payment. From start to finish, the entire process can take up to 30 days.

“Because of these timeframes, we expect to know more about the transition to ICD-10 after completion of a full billing cycle,” said Cavanaugh. 

ICD-10 features expanded alphanumeric code sets, as well as an expanded number of codes—68,000 vs. 13,000 under ICD-9—to identify disease etiology, anatomic site and severity.

According to a recent HME NewsPoll, 70% of respondents say they expect some disruption in cash flow as physicians and payers navigate the new code set.

However, there is one silver lining: Physicians and other practitioners under Medicare Part B won’t be denied for having the precise diagnosis code until Oct. 1, 2016

Should providers have any difficulty navigating the new code sets, CMS recommends contacting their MAC or the ICD-10 Coordination Center.