What the heck is taking so long to implement the ICD-10 coding protocol. Well, big money has managed to derail it for years since healthcare providers are leery about the new burdens of record-keeping involved with the new coding system. It’s complicated enough that concerns were for the payment process. Would the government use the expanded information on codes to deny claims, would payments be timely? How much would it cost a practice to migrate. In point of fact, it has cost millions of dollars to date.

What’s the big deal on the new codes? Although ICD-10 codes differ from ICD-9 in several ways – such as the number of characters used in each code and the use of an “x” placeholder – the biggest difference between the two coding sets is the number of codes involved. Because they are more complex and detailed, ICD-10 includes 69,099 diagnosis codes compared with only 14,315 ICD-9 codes.

So far, providers’ progress on switching over to the new codes has been varied. Mostly, people involved are intimidated by the tremendous challenge of the conversion. A major consideration is that more coders will be needed since the coding process will be magnified significantly, requiring far more codes and detail than were in the ICD-9 process. Experts recommend that duplicate coding be performed for several months while testing is monitored to make sure the whole process works.

Hand-in-hand with preparing for ICD-10 is getting ready for the new 5010 protocol for submitting electronic claims to Medicare and other payers. The 5010 protocol, which went into full effect on January 1, 2012, replaces the current protocol, known as 4010.

Providers and coders (and wannabees) who have questions about either ICD-10 or the 5010 protocol can find resources at the CMS website at  CMS.GOV/ICD10

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