On October 1, 2014, home health agencies are required to bill Medicare and other health insurers using ICD-10 codes to report medical diagnoses instead of ICD-9 codes. From Medicare’s perspective, the new codes will enhance the ability of the Centers for Medicare & Medicaid Services (CMS) to monitor quality, safety, and efficacy of care, monitor resource use, and prevent and detect fraud, waste, and abuse. We hope that it will also reduce Medicare and other payer’s need to request additional documentation to explain an individual’s condition. (more…)
Posts Tagged ‘ICD-9’
The Centers for Medicare & Medicaid Services (CMS) today announced proposed changes to the Medicare home health prospective payment system (HH PPS) for calendar year (CY) 2014 that would foster greater efficiency, flexibility, payment accuracy, and improved quality. Based on the most recent data available, CMS estimates that approximately 3.5 million beneficiaries received home health services from nearly 12,000 home health agencies, costing Medicare approximately $18.2 billion in 2012.
In the rule, CMS projects that Medicare payments to home health agencies in calendar year (CY) 2014 will be reduced by 1.5 percent, or $290 million based on the proposed policies. The proposed decrease reflects the effects of the 2.4 percent home health payment update percentage ($460 million increase), the rebasing adjustments to the national, standardized 60-day episode payment rate, the national per-visit payment rates, and the non-routine medical supplies (NRS) conversion factor ($650 million decrease), and the effects of ICD-9-CM coding adjustments ($100 million decrease).
In addition, the rule proposes routine updates to the HH PPS payment rates such as updating the payment rates by the HH PPS payment update percentage and updating the home health wage index for 2014. (more…)
Congressman Ted Poe (R-Texas) railed against the level of specificity in ICD-10 on the House floor Wednesday, including its nine different codes reflecting injury inflicted by a turkey and three ways to be injured by a lamppost.
Poe argued that the new system is excessive. It expands the 18,000 codes in ICD-9 for various injuries and diseases to more than 140,000 codes.
“Seems nine codes for a turkey assault is a bit silly,” Poe is quoted in The Hill. “It’s red tape, it’s bureaucracy, and this is what happens when clueless big government here in Washington starts telling people out in the workplace, doctors and patients, what they must do and when government intrudes into our lives with more regulations.” (more…)
By Sparkle Sparks & Annette Lee
Part 1: By Sparkle Sparks, PT, MPT, COS-C
Senior Associate Consultant, OASIS Answers, Inc., AHIMA Approved ICD-10 Coding Instructor
Last week, CMS confirmed through final rule publication that the implementation date for ICD-10 has officially changed to October 1, 2014. We all know that codes (currently of the ICD-9 variety) are a required part of our medical documentation. Many of us participate in one way or another in deciding which codes go where. But what do they really mean and how careful should we be in selecting them? When you consider what they’re used for the answer can be stunning. (more…)
Although the final rule on the proposed ICD-10 deadline change has yet to be published, it is important to continue planning for the transition to ICD-10. The switch to the new code set will affect every aspect of how your organization provides care, from registration and referrals, to software/hardware upgrades and clinical documentation.
A critical step in planning for the transition is to conduct an impact assessment of how the new code sets will affect your organization. Your impact assessment should include: (more…)
By Sparkle Sparks,
Join Sparkle at conference for “Prep for ICD-10-CM for Home Health Agencies” on July 26. She will also co-present Blueprint for OASIS-C Accuracy on July 22-23. Click here to check out the session summary in the conference brochure!
Following the continuing saga of the implementation of ICD-10 is like playing a game of “red light, green light.” Remember that? Someone yelled “green light” and frantic motion was set in high gear. Then someone yelled “red light” and you had to freeze, no matter how uncomfortable and hard to maintain your position was. If you inadvertently moved, you were out of the game. (more…)
By Sparkle Sparks, PT, MPT, COS-C
OASIS Answers, Inc.
With last week’s announcement by HHS Secretary Kathleen Sebelius that ICD-10 compliance will be delayed, providers are more confused than ever about what they should be doing to support ICD coding accuracy. While the government sorts this out we’d like to offer some prospective to our many home health clients and friends.OASIS Answers offers coding training for both ICD-9 and ICD-10 and will continue doing so until the government makes some definitive decisions regarding the implementation of ICD-10. ICD-10 is still coming. Secretary Sebelius said that “HHS will initiate a process to postpone the compliance date by which certain health entities have to comply with ICD-10.” The take home message is that ICD-10 is still coming.
What isn’t so clear however, is which entities the delay will apply to, and the delay timeline. Considering the current needs and future uncertainties, we’d like to recommend the following strategy for coding education for home care providers. (more…)