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Being a stickler for details is very crucial for employers of medical billers and coders. Pupils that are training to receive their medical coding and billing degree or certificate in Alabama should not take that fact lightly. You should know … Programs in Alabama Medical Billing and Coding Training

Being a stickler for details is very crucial for employers of medical billers and coders. Pupils that are training to receive their medical coding and billing degree or certificate in Alaska should not take that fact lightly. You should know that … Programs in Alaska Medical Billing and Coding Training

Employers that hire medical biller and coders look for people that have natural attention to detail or have acquired to have good attention to detail while they earn their medical and billing training in Arizona. You should know that the … Programs in Arizona Medical Billing and Coding Training

Being a stickler for details is very crucial for employers of medical billers and coders. Students that are training to get their medical coding and billing degree or certificate in Arkansas should not take that fact lightly. You should know … Programs in Arkansas Medical Billing and Coding Training

Being a stickler for details is very crucial for employers of medical billers and coders. Students that are training to obtain their medical coding and billing degree or certificate in California should not take that fact lightly. It is vital … Programs in California Medical Billing and Coding Training

Employers that hire medical biller and coders look for individuals that have ready attention to detail or have acquired to have good attention to detail while they earn their medical and billing training in Colorado. Students of medical billing and … Programs in Colorado Medical Billing and Coding Training

Employers that hire medical biller and coders look for individuals that have natural attention to detail or have acquired to have good attention to detail while they earn their medical and billing training in Connecticut. You should know that the … Programs in Connecticut Medical Billing and Coding Training

There are many aspects to medical billing and coding training. However, the supreme concern for employers of those with medical coding and billing training that were acquired in Delaware is attention to detail. Students of medical billing and coding should … Programs in Delaware Medical Billing and Coding Training

Employers that hire medical biller and coders look for people that have ready attention to detail or have learned to have good attention to detail while they earn their medical and billing training in Florida. You should know that the … Programs in Florida Medical Billing and Coding Training

Employers that hire medical biller and coders look for individuals that have ready attention to detail or have learned to have good attention to detail while they earn their medical and billing training in Georgia. You should know that the … Programs in Georgia Medical Billing and Coding Training

Employers that hire medical biller and coders look for individuals that have ready attention to detail or have learned to have good attention to detail while they earn their medical and billing training in Hawaii. It is vital for anyone … Programs in Hawaii Medical Billing and Coding Training

Being a stickler for details is very crucial for employers of medical billers and coders. Students that are training to obtain their medical coding and billing degree or certificate in Idaho should not take that fact lightly. Students of medical … Programs in Idaho Medical Billing and Coding Training

Being a stickler for details is very important for employers of medical billers and coders. Students that are training to acquire their medical coding and billing degree or certificate in Illinois should not take that fact lightly. You should know … Programs in Illinois Medical Billing and Coding Training

Being a stickler for details is very important for employers of medical billers and coders. Pupils that are training to obtain their medical coding and billing degree or certificate in Indiana should not take that fact lightly. It is vital … Programs in Indiana Medical Billing and Coding Training

There are many views to medical billing and coding training. However, the supreme concern for employers of those with medical coding and billing training that were obtained in Iowa is attention to detail. Students of medical billing and coding should … Programs in Iowa Medical Billing and Coding Training

Employers that hire medical biller and coders look for people that have natural attention to detail or have learned to have good attention to detail while they earn their medical and billing training in Kansas. Students of medical billing and … Programs in Kansas Medical Billing and Coding Training

There are many views to medical billing and coding training. However, the paramount concern for employers of those with medical coding and billing training that were acquired in Kentucky is attention to detail. Students of medical billing and coding should … Programs in Kentucky Medical Billing and Coding Training

There are many views to medical billing and coding training. However, the paramount concern for employers of those with medical coding and billing training that were acquired in Louisiana is attention to detail. You should know that the job could … Programs in Louisiana Medical Billing and Coding Training

Being a stickler for details is very important for employers of medical billers and coders. Pupils that are training to receive their medical coding and billing degree or certificate in Maine should not take that fact lightly. It is vital … Programs in Maine Medical Billing and Coding Training

There are many aspects to medical billing and coding training. However, the supreme concern for employers of those with medical coding and billing training that were obtained in Maryland is attention to detail. You should know that the job could … Programs in Maryland Medical Billing and Coding Training

There are many aspects to medical billing and coding training. However, the overriding concern for employers of those with medical coding and billing training that were acquired in Massachusetts is attention to detail. It is vital for anyone in this … Programs in Massachusetts Medical Billing and Coding Training

Being a stickler for details is very important for employers of medical billers and coders. Pupils that are training to get their medical coding and billing degree or certificate in Michigan should not take that fact lightly. Students of medical … Programs in Michigan Medical Billing and Coding Training

Employers that hire medical biller and coders look for individuals that have natural attention to detail or have acquired to have good attention to detail while they earn their medical and billing training in Minnesota. It is vital for anyone … Programs in Minnesota Medical Billing and Coding Training

There are many aspects to medical billing and coding training. However, the paramount concern for employers of those with medical coding and billing training that were acquired in Wyoming is attention to detail. It is vital for anyone in this … Programs in Wyoming Medical Billing and Coding Training

There are many views to medical billing and coding training. However, the overriding concern for employers of those with medical coding and billing training that were obtained in Mississippi is attention to detail. Students of medical billing and coding should … Programs in Mississippi Medical Billing and Coding Training

Employers that hire medical biller and coders look for individuals that have natural attention to detail or have acquired to have good attention to detail while they earn their medical and billing training in Missouri. It is vital for anyone … Programs in Missouri Medical Billing and Coding Training

Being a stickler for details is very essential for employers of medical billers and coders. Students that are training to receive their medical coding and billing degree or certificate in Montana should not take that fact lightly. It is vital … Programs in Montana Medical Billing and Coding Training

There are many aspects to medical billing and coding training. However, the supreme concern for employers of those with medical coding and billing training that were acquired in Nebraska is attention to detail. Students of medical billing and coding should … Programs in Nebraska Medical Billing and Coding Training

There are many aspects to medical billing and coding training. However, the dominant concern for employers of those with medical coding and billing training that were acquired in Nevada is attention to detail. You should know that the job could … Programs in Nevada Medical Billing and Coding Training

Employers that hire medical biller and coders look for people that have ready attention to detail or have learned to have good attention to detail while they earn their medical and billing training in New Hampshire. Students of medical billing … Programs in New Hampshire Medical Billing and Coding Training

Employers that hire medical biller and coders look for individuals that have natural attention to detail or have acquired to have good attention to detail while they earn their medical and billing training in New Jersey. You should know that … Programs in New Jersey Medical Billing and Coding Training

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There are many views to medical billing and coding training. However, the paramount concern for employers of those with medical coding and billing training that were acquired in New York is attention to detail. It is vital for anyone in … Programs in New York Medical Billing and Coding Training

There are many views to medical billing and coding training. However, the overriding concern for employers of those with medical coding and billing training that were obtained in North Carolina is attention to detail. It is vital for anyone in … Programs in North Carolina Medical Billing and Coding Training

Being a stickler for details is very essential for employers of medical billers and coders. Students that are training to receive their medical coding and billing degree or certificate in North Dakota should not take that fact lightly. You should … Programs in North Dakota Medical Billing and Coding Training

There are many aspects to medical billing and coding training. However, the paramount concern for employers of those with medical coding and billing training that were obtained in Ohio is attention to detail. Students of medical billing and coding should … Programs in Ohio Medical Billing and Coding Training

Being a stickler for details is very important for employers of medical billers and coders. Pupils that are training to acquire their medical coding and billing degree or certificate in Oklahoma should not take that fact lightly. It is vital … Programs in Oklahoma Medical Billing and Coding Training

Employers that hire medical biller and coders look for people that have natural attention to detail or have acquired to have good attention to detail while they earn their medical and billing training in Oregon. Students of medical billing and … Programs in Oregon Medical Billing and Coding Training

There are many aspects to medical billing and coding training. However, the dominant concern for employers of those with medical coding and billing training that were acquired in Pennsylvania is attention to detail. Students of medical billing and coding should … Programs in Pennsylvania Medical Billing and Coding Training

Employers that hire medical biller and coders look for people that have natural attention to detail or have learned to have good attention to detail while they earn their medical and billing training in Rhode Island. Students of medical billing … Programs in Rhode Island Medical Billing and Coding Training

Employers that hire medical biller and coders look for people that have natural attention to detail or have acquired to have good attention to detail while they earn their medical and billing training in South Carolina. Students of medical billing … Programs in South Carolina Medical Billing and Coding Training

Employers that hire medical biller and coders look for people that have natural attention to detail or have acquired to have good attention to detail while they earn their medical and billing training in South Dakota. You should know that … Programs in South Dakota Medical Billing and Coding Training

Employers that hire medical biller and coders look for individuals that have natural attention to detail or have learned to have good attention to detail while they earn their medical and billing training in Tennessee. It is vital for anyone … Programs in Tennessee Medical Billing and Coding Training

Employers that hire medical biller and coders look for individuals that have natural attention to detail or have acquired to have good attention to detail while they earn their medical and billing training in Texas. It is vital for anyone … Programs in Texas Medical Billing and Coding Training

Being a stickler for details is very important for employers of medical billers and coders. Pupils that are training to obtain their medical coding and billing degree or certificate in Utah should not take that fact lightly. You should know … Programs in Utah Medical Billing and Coding Training

There are many aspects to medical billing and coding training. However, the paramount concern for employers of those with medical coding and billing training that were obtained in Vermont is attention to detail. You should know that the job could … Programs in Vermont Medical Billing and Coding Training

Being a stickler for details is very important for employers of medical billers and coders. Pupils that are training to get their medical coding and billing degree or certificate in Virginia should not take that fact lightly. Students of medical … Programs in Virginia Medical Billing and Coding Training

Employers that hire medical biller and coders look for people that have ready attention to detail or have acquired to have good attention to detail while they earn their medical and billing training in Washington. It is vital for anyone … Programs in Washington Medical Billing and Coding Training

There are many aspects to medical billing and coding training. However, the overriding concern for employers of those with medical coding and billing training that were acquired in West Virginia is attention to detail. It is vital for anyone in … Programs in West Virginia Medical Billing and Coding Training

There are many aspects to medical billing and coding training. However, the overriding concern for employers of those with medical coding and billing training that were acquired in Wisconsin is attention to detail. It is vital for anyone in this … Programs in Wisconsin Medical Billing and Coding Training

Table of Contents

Chapter Five

Implementation

ICD-10 Guide contents

Getting ICD-10 and HIPAA Version 5010 up and running is going to be a long and daunting task, so it’s best to be prepared before hand. You should already have hit some of the check points for implementation, but whether you have or not, this helpful guide should make the process a little easier to get through.

Implementation Time Line:

By January 1^st, 2010: Payers and providers should have began internal testing of HIPAA Version 5010 standards, to make sure the program is running smoothly well in advance of deadlines.
By December 31^st, 2010: Payers and providers should have completed internal testing of version 5010 by this date. This is the first checkpoint for compliance, so it should be completed. If you haven’t completed it yet, get it done soon, because most people have already moved on to external testing.
By January 1^st, 2011: Payers and providers began external testing of HIPAA Version 5010. The Centers for Medicare & Medicaid Services (CMS) began accepting 5010 claims on this date, but HIPAA Version 4010 claims are still accepted.
By December 31^st, 2011: Payers and providers should complete external testing of HIPAA Version 5010. This is the checkpoint for compliance, so make sure it’s marked on your calendar.
By January 1^st, 2012: All electronic claims submitted to CMS must use version 5010, as 4010 claims will no longer be accepted. If you aren’t version 5010 compliant by this point, you aren’t going to be able to submit your claims.
By October 1^st, 2013: All claims for medical diagnoses and inpatient procedures must use ICD-10 codes by this date. The change does not affect CPT codes, which will continue to be used for outpatient services.

Meeting this time line will take a lot of foresight and forward planning. The amount of training needed is quite large, and you will have to budget both time and money to account for it. Outside professionals will need to be hired into your hospital for training, or you may have to send employees away to training boot camps or seminars. There are lots of training options available, so make sure you do your research and pick the one that makes the most fiscal sense for your company, especially if you are a vendor and your clients are relying on your software to help them through the transition.

Here are some resources to help you find a training program:

AAPC ICD-10 Training Program
AHIMA-Approved ICD-10-CM/PCS Trainers (organized by state)
Sponsored ICD-10 Teleconferences

About the Code

The most notable change from ICD-9 to ICD-10 is actually the number of digits used in the code. Instead of the familiar five digits, ICD-10 will have seven digits, which break down as follows:

1^st digit: alphabetical (A-Z, not case sensitive)
2^nd digit: numerical
3^rd digit: alphabetical (A-Z, not case sensitive) or numerical, depending on the diagnosis
4^th-7^th digits: alphabetical (A-Z, not case sensitive)

Because the new code is longer than the old, databases than you translate will take up more space than

Some areas of your business are going to be more heavily affected by the code change than others. You should focus your training efforts in these areas, and then work out from there. These areas are as follows:

Claims Processing – For part A/B, the new system uses the Fiscal Intermediary Standard System (FISS), which is also used by fee-for-service (FFS)/Fiscal Intermediaries (Fis)/Medicare Administrative Contractors (MACs). FISS essentially edits institutional claims for consistency and administrative purposes. For non-institutional medicare claims under Part B, you have to use the Multi-Carrier Systems (MCS) for both physicians and non-physician practitioners.
Payment Policies – Medicare payment policy will be refined under CMS, responding to the changes that have happened over the years. Anyone working with FFS will have to have a clear understanding of the new code, as it affects payment policies significantly.
CMS System Repositories – System repositories and their data outputs process, including management and storage of CMS claims, will be affected by the change. Each system will need updated algorithms, characters and field lengths. In order to facilitate data trending analysis, ICD-9 coded files will need to be translated into ICD-10.
Quality Measures and Payment Initiatives – Measure specifications and algorithms are developed using ICD-9 codes, which means that they will all have to be re-developed to accommodate ICD-10 codes. While mapping tools do exist, the translation is not exact, and it would be better to just re-calculate the algorithms. The following payment initiatives have incentives for development, which you may want to keep in mind:
1. PQRI program – for physicians and other outpatient practitioners
2. RHQDAPU program – for inpatient hospitals
3. HOP QDRP – for outpatient hospitals
Assessment Tools – The process for developing, collecting and reporting assessment instrument data in most facilities will be affected by the coding change. They will need to be re-programmed and reformatted for ICD-10.
Risk Adjustment – Because risk scores are calculated using lots of different data points, including ICD-9 codes, the code change will affect risk adjustment systems. Each individual system will need to be evaluated for the change over to ICD-10.
Quality Improvement Activities – QIOs will be just as affected by the ICD-10 change as other medical facilities. Because QIOs are responsible for ensuring that medicare is only paying for necessary and appropriate treatments, understanding of diagnosis codes is key.

For more detailed coverage of this, visit the CMS ICD-10 Planning Executive Report Summary.

There are lots of summaries and information guides online that can help you figure out how, exactly ICD-10 affects your organization. Here are some resources to guide you through the transition:

Medical Billing & Coding

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