What is ICD-10 Compliance?

The healthcare industry is currently focused on the EHR incentive program but 2014 will see another significant change that will affect more than just health care providers: the transition from ICD-9 to ICD-10. Unlike the meaningful use program which is meant solely for hospitals and health professionals, all entities covered under HIPAA are required to meet the October 1 deadline for ICD-10 compliance.
ICD 10 is the 10th revision of the international system for disease and symptom classification, developed by the World Health Organization in 1992. It is a method of coding that captures the state of a patient’s health as well as treatment procedures. The deadline for ICD 10 transition has been pushed back repeatedly leaving the US lagging behind other developed nations.
ICD-9, currently in use, was largely implemented decades ago and is considerably out of date with modern medicine. The codes cannot capture pertinent details about treatment procedures and diagnoses necessary for the health care sector today. The healthcare terms used are quite obsolete and several categories are already full, meaning that new disease codes cannot be added any longer. The 10th revision updates the codes and brings it in line with modern medicine. It also allows for the representation of more accurate and detailed information related to diagnoses and treatment procedures.
Healthcare providers will need to work with their EHR/billing software vendors and payers to make sure that they are ICD 10 compliant before the October deadline. Any software that utilizes ICD-9 such as practice management software needs to be compatible with the new system. Accurate coding is a necessity for quick claims processing and failure to code properly can lead to a greater number of claims being rejected. This can adversely affect the revenue cycle and significantly reduce profits.
Dental practices need to make sure that their software will accept ICD 10 codes and process claims without errors. All staff should be made familiar with ICD 10 through general briefings, with more specialized training for employees directly involved in coding. Providers will also want to focus on the most commonly used codes first. For example, an orthodontist will rarely use gynecology codes, so those can be left for later. A series of test claims should be run to verify that they are being accepted by the payer as expected. Any coding process that is currently automated should also be audited to make sure that the output is correct.
Dovetail is a complete electronic dental record and practice management software solution which is 2014 ONC certified. For additional information on the program, please visit this page.


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