HBMA testifies before NCVHS on ICD-10 Readiness
Learn from Past, Don't Repeat 5010 Mistakes
LAGUNA BEACH, Calif., June 28, 2013 /PRNewswire-USNewswire/ -- Because of its
significant role in revenue cycle management, the Healthcare Billing and
Management Association (www.hbma.org) was invited recently to participate in
discussions with the National Committee on Vital and Health Statistics (NCVHS)
Subcommittee on Standards in Washington, D.C. to provide an update on the status
of transitioning from ICD-9 CM to ICD-10 CM by the October 1, 2014 effective
date. 1. While CMS has adopted a definition of "ready" and developed the tools and
checklists to assist every provider, organization, payor and vendor to
validate they are ready on October 1, 2014, a subsequent announcement by
CMS that they will not perform any external testing is extremely
problematic for the industry. End-to-end testing by all payors, to meet
the definition of "ready" must occur to ensure a smooth ICD-10 CM
implementation. Failure to engage in meaningful end-to-end testing is a
recipe for disaster.
2. CMS must establish period benchmarks that cannot be ignored to assess the
"readiness" status for all facts of the healthcare industry.
3. There must be clear pronouncement that there is no vendor, EHR, coding
assist tool, map, crosswalk or other product that will solve the problem
of excellent medical record documentation and accurate coding.
Physicians and staff must be fully prepared with adequate training to
operate compliantly and not rely on false proclamations of marketed
solutions.
4. Payor policies will be critical to the appropriate adjudication of
claims. Currently, there is a wide variance among payors in stated
policies. It is imperative that policies are published by October 1,
2013 in order to allow adequate time for education and training, data
analysis and other preparations for ICD-10 CM.
5. Any payor that is currently only accepting claims by 4010 format must be
fully 5010 compliant by January 1, 2014 in order to be ICD-10CM ready.
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