Although ICD-10 implementation has gone amazingly well, there are specialty-specific challenges arising for some practices and groups. For example, orthopedics has an incredibly large list of extremely specific codes. That can be very frustrating for physicians who must treat patients when it is not their primary or only specialty, and they may…

Under ICD-10, submitting compliant and accurate claims and minimizing the negative impact to clients’ cash flow were concerns shared by all those in the coding and medical billing community. While the transition has been relatively smooth as it pertains to our internal operations, there have been unanticipated challenges on the…

ICD-10 has been a non-event for clearinghouses, which are continuing to report little impact on their day-to-day business operations. Availity, one such entity, has encountered a few minor issues over the past month, primarily related to data not being submitted correctly by providers or payers having slightly different interpretations of…

As we begin coding inpatient rehabilitation facility (IRF) claims using ICD-10, it is prudent to review Medicare’s clarification about the use of seventh-character extension in ICD-10-CM under the IRF Prospective Payment System (PPS). Earlier this year, the Centers for Medicare & Medicaid Services (CMS) issued the following clarification related to…

Here are some lessons learned over the last year as we have prepared for an organization-wide approach to implementing ICD-10 across a very large health system in San Diego. There are three specific areas that should be considered when implementing a new coding process for hospice programs, which went into…

I have told you about some of my pet peeves before, and below is another. How many of you reading this article hate Convention A.11 when it comes to PCS guidelines? Come on and admit it: you are silently chuckling about it now! What is A.11?

Various industry agencies, organizations, payers, providers, and physicians are reporting that there has been a reasonably smooth start for such a gigantic undertaking as the recent implementation of ICD-10. Like all momentous challenges, there have been some hot spots, some notable failures, some minor toe-stubbing, and some smooth sailing. Keep…

Claims appear to be moving along the I-10 with little congestion in the early going following implementation of the new code set. This week’s update will cover Wisconsin Physician Services (WPS), First Coast Service Options, and CGS Medicare and its local coverage determination (LCD) issues and resolutions. Overall, it appears…

America’s healthcare system has been submitting ICD-10 claims at the rate of 4.6 million daily since the conversion to the new coding set took effect Oct. 1, according to the Centers for Medicare & Medicaid Services (CMS). The rate of claim denials is 10.1 percent of all claims being processed,…

Some sectors of the healthcare industry are experiencing more success than others in adjusting to the Oct. 1 implementation of ICD-10, but home health agencies and hospice facilities are enjoying a relatively seamless transition thus far, an industry sector leader reported this week.