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Why ICD-10 is exactly like Y2K

September 30, 2015
by Julie Miller, Editor in Chief
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Remember the final days leading up to January 1, 2000? Describing a technological apocalypse complete with massive financial fallout became a favorite pastime for everyone from government leaders to grocery store clerks. As it turned out, very few organizations experienced Y2K issues, and the pop culture of the moment faded quickly.

I predict tomorrow's ICD-10 launch will be similar.

Yes, there are still too many behavioral health providers who are stoically ignoring the transition, fooled into thinking their tech partners will simply handle it, but if nobody flips the switch at midnight tonight, daily operations aren’t going to blow up. Every patient will still receive a solid diagnosis and expert care from clinicians.

However, the back-office work might become cumbersome when claims start to come back rejected. The real question is when that eventuality will occur in your organization. The answer will be different for each provider, depending on the rules set by your payer partners. At the very least, you’ll want to find out when the rejections—and the associated payment losswill begin.

The Centers for Medicare and Medicaid Services (CMS)—which has set the pace for the ICD-10  transition for the healthcare industry as whole—has indicated somewhat quietly that it will not instantly reject Medicare claims that arrive with ICD-9 codes for the next 12 months.

Here’s why that makes sense. There are no doubt claims in process right now that won’t be magically adjudicated by midnight. I’m no tech expert, but you have to think that from a practical perspective, the Medicare systems must have the ability to clear out the old claims even while the new ICD-10 claims are pouring in.

The question for you is whether your payer partners have the same grace period. You’ll find out soon enough. The day your claims get rejected is obviously not the day to start learning your way around ICD-10.

ICYMI: Your ‘top 10’ ICD-10 codes

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Julie Miller

Editor in Chief

Julie Miller

@editor_JMiller

Julie Miller has more than 14 years of experience observing, analyzing and reporting on various...