ICD-10 Update

By Randy Wilson, Chief Financial Officer and Chief Revenue Cycle Officer

Now that we are several months past the ICD-10 implementation date, it’s time to look back and see if it was as terrible as we thought it would be.  There were fears that insurance companies would use this opportunity to withhold payment and we would all be mired in a sea of denials.

CMS stated the first twelve months would be an “educational” period where Payers would provide feedback to the providers.  This helped alleviate some of the fears regarding the surge of denials.  In the past couple of months, I have chatted with a number of my colleagues in the Emergency Medicine Revenue Cycle world and they have all responded in the same way.  No one has seen educational denials from any payers, including Medicare.  Either we all got it right or we may yet see the “sea of denials”.

At this point I think it is important to continue to educate providers on documentation needs in order to achieve the proper level of specificity for ICD-10, and continue to monitor EOBs for bulletins and additional information related to ICD-10. Hopefully we will see some educational feedback.  October 1, 2016 is another red-letter day and we should remain vigilant as we watch for the ICD-10 denials.