Prepare Now for Transition to ICD-10
Learn more about Humana's readiness plan and find answers to your frequently asked questions for ICD-10.
On October 1, 2014, the United States health care industry will transition from the International Classification of Diseases, 9th Edition (ICD-9), to the International Classification of Diseases, 10th Edition (ICD-10), for medical diagnosis and inpatient procedure coding. ICD-10 diagnosis codes must be used for all health care services provided in the U.S. ICD-10 procedure codes must be used for all hospital inpatient procedures. Claims with ICD-9 codes for services provided on or after the compliance deadline cannot be processed.
ICD-10 will affect diagnosis and inpatient procedure coding for everyone covered by the Health Insurance Portability and Accessibility Act (HIPAA). Health care providers, payers, clearinghouses and billing services must be prepared to comply with the transition to ICD-10. All electronic transactions must use Version 5010 standards, which have been required since January 1, 2012. Unlike the older Version 4010/4010A standards, Version 5010 accommodates ICD-10 codes. Humana became fully Version 5010 compliant on January 1, 2012. Humana is scheduled to be fully functional and compliant with the ICD-10 implementation deadline as well.
CMS recommends that health care providers look for specialty-specific ICD-10 training offered by societies and professional organizations. ICD-10 coding training will be integrated into the continuing education units (CEUs) that certified coders must take to maintain their credentials. ICD-10 resources and training materials will be available through CMS, professional associations and societies, software and system vendors.
CMS’ suggested training time recommends that health care providers start intensive training no sooner than six to nine months prior to the implementation for coders who will not assign ICD-10-CM/PCS codes until compliance date. Hospital inpatient coders will need to have 50 hours ICD-10-CM/PCS training. Other coders will require 16 hours of ICD-10-CM.
Health care providers will also need to confirm that billing services, clearinghouses and practice management software vendors are ready to provide the support they need in order to meet the compliance date.
CMS has a dedicated website (www.cms.gov/ICD10) to provide the latest information on training opportunities for health care providers.
Humana plans to conduct external end-to-end testing with a select group of early adopters during the third and fourth quarters of 2013. Health care providers who would like to participate in Humana’s testing may send an email to ICD10inquiries@humana.com for more information.
This information is only a high-level summary of certain provisions of the health care reform law. This information does NOT attempt to summarize all provisions of the health care reform law. This information is not and should NOT be used as legal or tax advice; it should not be used as a basis for decisions regarding how health care reform law will affect you and/or your business. Should you have any questions on how the health care reform law (including the high level summary of certain provisions of health care reform) will affect you and/or your business, you should seek professional advice from attorneys or other advisors.