Is Medicare Ready for ICD-10?

For many physicians in private practice in the United States, Medicare is a significant payer from whom they receive reimbursements.  The many years of using ICD-9 coding for submitting claims to Medicare has made this process second nature for medical billers and coders.  With familiarity comes overconfidence that subsequent changes caused by the transition from ICD-9 to ICD-10 will be simple to navigate.

In fact, a recent survey in the Fall 2013 indicates nearly 90% of providers express some amount of confidence that they will be prepared for ICD-10. Twenty-two percent are even “very confident”, but 74% haven’t even started implementing their transition plan.

There is also widespread belief that claims will be processed in a relatively timely manner with few disruptions to the revenue cycle. Forty-three percent think that their productivity will drop less than 20% after the transition date. One quarter of respondents think that more than 80% of their claims will be reimbursed without a hitch.

Now back to Medicare.  Without proper testing of the claims submission system with ICD-10 coding, physician practices are adopting “blind faith” that the system will work properly.  Up until recently, Medicare indicated that it would perform no end to end testing and would start accepting ICD-10 claims on October 1, 2014.  Now Medicare has committed to allow for end to end testing of the claims submission system from March 3 – 7, 2014 in an effort to make sure the system works correctly.

Sure up your confidence in Medicare paying the ICD-10 claims you submit. Insist that your billing company or billing staff sign up for the Medicare end to end testing between March 3 – 7, 2014.