I'm ready for my new ICD-10 label


Over the past year, whenever I’ve gone to the doctor (luckily, not often), I am tempted to ask: “Are you ready for ICD-10?”

Now that it’s upon us, I wish I had. After all, everything is fodder when you are a writer. HME providers by and large say physicians are not prepared. I am inclined to believe them.

On the bright side, it does sound as though most HME providers are as ready as they can be, which is good. I did have one provider post a comment on my recent story on the ICD-10 transition, in which he questioned whether there is a grace period for HME providers. There is not, but there is one for physicians, which will be of some benefit.

Let me explain it as I understand it:

The auditors have apparently been instructed NOT to deny a DME claim based solely on the specificity of the ICD-10 code. As long as the physician uses a valid code in the same family, you should be safe.

So, for example, if the physician uses one of the old codes for diabetes (you knew that’s the example I was going to use) instead of one of the new, more specific codes, you’re covered. If you forget to include one of the 57,000 other things required on the claim, you’re not. If the code applies to COPD on a claim for diabetes, you're also not.

I'd like to take a moment here to apologize for taking a week to see the comment, JGiles, but we don't have a dedicated person to do this. That's not to say that work ain't nothing but a party. (sorry, couldn't resist).

Speaking of which, when I first learned about this change, I was fascinated (and a little horrified on behalf of the entire medical community).

I actually tried looking up and comparing ICD-9 vs ICD-10 codes for diabetes. This proved impossible for a layperson like myself.

But I will definitely be curious to see how my code changes at my next visit. 



The Dear Physician letter that the DMEMACs issued on 9/24/2015 states the ICD must in the medical record for DMEPOS claims despite the 12 month flexibility for physicians.  Do you think DME claims will be denied on post payment review if the medical records only contain the corresponding ICD9 code?