It's been a year since the big lift of converting the entire claim stream of the healthcare industry to the larger and more granular ICD-10 family of diagnostic and procedural codes.
The Oct. 1, 2015 launch went smoothly compared with the warnings of technological meltdown and cash-flow Armageddon that provoked three delays totaling four years.
Claims flows, measured by claims denial rates, returned to normal after a few months, according to the CMS and confirmed by industry experts.
“This is the Y2K of coding,” said Dr. John Cuddeback, chief medical informatics officer of the American Medical Group Association. “I think people did a pretty good job of preparing.”
But this month, physicians face a new ICD-10 challenge. Last year, the CMS granted physicians a one-year grace period, promising not to deny Medicare Part B claims for lack of specificity of ICD-10 coding. Many commercial payers similarly gave physicians “flexibility,” but that grace period ended Oct. 1.
Earlier this year, the CMS and HHS released updates to the codes that contained what Sue Bowman, senior director of coding policy and compliance at the American Health Information Management Association, called “some hiccups in the hospital DRG system,” But, she added, “I think we're past most of that.”
Experts say it's too early to tell whether the switch to more stringent coding requirements will snag docs' claims. “We're keeping our ears open to see if that has had any impact on claims,” said Robert Tennant, director of health information policy for the Medical Group Management Association, a trade association for managers of physician office-based practices.