Managed Care

Convert Now To ICD-10 Coding

By ROB Editors

August 12, 2015

Excerpted from the newly published 2015 version of Vision Source’s Navigation Guide to Health Care Reform for Independent Optometrists.

ICD-10 is less than 50 days away. Here are 5 steps to ICD-10 success.

CLICK HERE or on the image to the left to download the fullreport, published in April 2015.

The new ICD-10 codes–which go into effect October 1, 2015, are considerably more complex than the ICD-9 set, with 68,000 codes compared to 13,000 ICD-9 codes, adding additional specificity on disease diagnosis, severity and treatment stages. A major change is that the ICD-10 codes require a practitioner to specify the laterality or bi-laterality of a condition, as appropriate. Under ICD-9, the coder was supposed to specifify laterality or bilaterality using modifiers, so the only new thing here is that laterality or bilaterality is a part of the base code instead of needing a modifier. Each ICD 10 code has three to seven characters in the following sequence:

• Category (letter)

• Etiology (number)

• Anatomic site (letter or number)

• Severity (letter or number)

• Extender (letter or number)

Action Plan

1. Confirm that your practice management software system has been, or will be, updated to support the new codes. Make sure the third parties you work with will accept your software sending ofthe new codes. Do a trial run.

2. Train doctor and staff on the structure of the new coding system and differences from the ICD-9 structure.

3. Review documentation from Medicare and major insurers on the conversion, administrative procedures and compliance standards.

4. Establish a process for how ICD-10 codes will be selected (manual, look-up program).

5. Practice ICD-10 code selection as soon as possible.

6. Take your top 20 codes used in 2014 and convert them to ICD-10, then create a “fee ticket” (“superfee slip”), so the only codes you have to look up are the unusual ones.

Resources
AOA 2015 Codes for Optometry Book and Express Mapping Reference Card

Includes Codes for Optometry, a resource that provides tools to help ODs transition from ICD-9-CM to ICD-10-CM. It clarifies the new diagnosis codes in detail to assist in making correct ICD-10-CM coding choices.

2015 AOA ICD-10 Codes for Optometry w/ Express Mapping Card & AMA CPT

This coding bundle includes three guides approved and recommended by AOA’s coding experts: 2015 AOA Codes for Optometry (ICD-10), 2015 ICD-10 CM AOA Express Mapping Card (not sold separately) and 2015 AMA CPT Professional Edition.

CMS and AMA Announce Efforts to Help Providers Get Ready for ICD-10

The Centers for Medicare & Medicaid Services (CMS) announced that it is working with the American Medical Association (AMA) to ease the transition.

>>Click HERE to read ROB’s recent coverage of this news.>>

Prepare Your Staff for ICD-10

ROB Professional Editors Mark Wright, OD, FCOVD, and By Carole Burns, OD, FCOVD, offer a three-step process for readying staff for ICD-10.

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