The move from ICD-9 to ICD-10 diagnosis codes will be massive, and experts warn that everyone in healthcare (mental & behavioral health included) need to plan and prepare now in order to keep our footing during this immense change. Download our guide for a smooth transition.
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8 Steps to a Smooth ICD-10 Transition
1. Your flexible, comprehensive EHR solution! www.pimsyemr.com 8 Easy Steps for ICD-10
8 Steps to a Smooth ICD-10 Transition
Ready to get started on ICD-10? Click here and here for ICD-10 background info and see
below for Additional Resources â meanwhile, hereâs a step-by-step action plan:
1) Talk to your payers: Start calling your payers now, whether insurance companies or
Medicaid/Medicare, and find out what codes they will be requiring, especially for your niche
market (mental health, ABA, substance abuse, IOP, speech therapy, nutrition, etc).
Will they call for any DSM-5? Do they have any special ICD-10 stipulations? Once you know
what you need to provide, the path is somewhat set for you.
2) Decide which conversion pathway you want to follow:
If y0u donât use DSM, thereâs only one way to go: ICD-9 to
ICD-10. However, if you want or need to use DSM, itâs a
little more complicated. Do you want to convert from
DSM-IV to DSM-5 to ICD-10? Are you already using DSM-
5? Do your payers require both DSM and ICD?
Pick your conversion pathway and determine how you will
convert your codes: there are multiple options available,
from conversion crosswalks & software for purchase, to
free conversion tools on the Web. Be sure to confirm the
accuracy of whatever conversion tool(s) you choose, as they can differ greatly in quality!
3) Train your staff: After deciding on your best conversion pathway, educate your employees
on the predicted changes and how they might affect business. Thoroughly train your staff on
the new office practices by late spring/early summer to allow plenty of time for testing.
Keep in mind that ICD-10 codes are required for dates of services after 10/1/15, but claims
processed with a date of service prior to 10/1/15 should still be coded in ICD-9, regardless of
when they are submitted. Additionally, non-HIPAA covered entities such as workmanâs
compensation are not required to transition to ICD-10. You will need to train your staff on
recognizing these distinctions and billing fluidly with both sets of codes.
4) Schedule testing with your payers for late spring/early summer to leave plenty of time for
addressing complications before the 10/1/15 deadline. You wonât fully understand how much
ICD-10 will affect you until you test the new codes with your payers, so you may need to
rework office practices and retrain your employees after testing is conducted.
5) Schedule testing with your practice: The hardest part of this transition will be getting your
staff trained to pick the right code and getting used to business under this new framework â
2. Your flexible, comprehensive EHR solution! www.pimsyemr.com 8 Easy Steps for ICD-10
after youâve tested with your payers and implemented any needed adjustments (including
retraining), test your employees and make sure everything is running smoothly for them.
6) Save and set aside: put away as much money as possible in case payments are delayed
during the transition (remember the January 2013 CPT debacle for mental health!?)
7) Create updated revenue plans: if it takes your
staff 2-3 times as long to process notes or claims,
what changes do you need to make to ensure
business viability?
8) Hire an expert: the easiest way to make this
challenge as smooth as possible is to secure an
ICD-10 expert to conduct a risk assessment of
your practice and get you on track for a successful
transition. They can determine how much you
will be impacted and create an implementation
timeline to ensure you are testing the new codes
early enough to catch & fix errors and meet the deadline. Because of the complex interactions
between DSM-IV & DSM-5 and ICD-9 & 10, itâs a good idea to hire a consultant well-versed in
mental & behavioral health.
Additional Resources
PIMSY ICD-10 Resource Center
PIMSY ICD-10 Forum
ICD-10 for Behavioral Health blog
How do ICD, DSM, and CPT interact for mental health?
Transition to ICD-10
AAPC Fast Forward Top 50 Codes Conversion PDF
Centers for Medicare and Medicaid Services (CMS) ICD-10 Provider Resources
ICD-10 Implementation Guide for Small and Medium Practices
Small and Medium Practices ICD-10 Checklist
ICD-10 Implementation Guide for Large Practices
American College of Physicians ICD-10 Resource Center
ICD-10 Conversion Tool and Resources
AAPC Coding Books
See more about PIMSY EHR and how it can enhance compliance.
Disclaimer: Ultimately, it is the responsibility of each practice to ensure ICD compliance, including the 10/1/14 ICD-10 transition.
PIMSY EMR/SMIS has gathered information from various resources believed to be authorities in their field. However, neither PIMSY
EMR/SMIS nor the authors warrant that the information is in every respect accurate and/or complete. PIMSY EMR/SMIS assumes no
responsibility for use of the information provided. Neither PIMSY EMR/SMIS nor the authors shall be responsible for, and expressly
disclaim liability for, damages of any kind arising out of the use of, reference to, or reliance on, the content of these educational
materials. These materials are for informational purposes only. PIMSY EMR/SMIS does not provide medic al, legal, financial or other
professional advice and readers are encouraged to consult a professional advisor for such advice.