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Mastering Medicare Seminars- OASIS and RACS

by Beacon Health Staff  


Originally Published: September 03, 2012
ICD-10 Compliance Deadline Delayed One Year

On August 24, the Department of Health and Human Services (HHS) announced a one-year delay to the deadline for healthcare providers to become compliant with ICD-10 coding standards. Providers now have until Oct. 1, 2014 to implement the new system.

Currently, providers use ICD-9 to code diagnoses and procedures. The current system utilizes 13,000 codes, while ICD-10 will include 68,000 codes. The proposed rule was initiated when many provider groups expressed serious concerns about their ability to meet the Oct. 1, 2013 compliance date. The change in the compliance date for ICD-10 will “give providers and other covered entities more time to prepare and fully test their systems to ensure a smooth and coordinated transition to these new code sets,” according to an April 9 press release.

Another part of the final rule establishes a health plan identifier (HPID). Authorized by the Affordable Care Act, HPIDs will help simplify the existing process for determining a patient’s eligibility for care and coverage, according to HHS.

“These new standards are a part of our efforts to help providers and health plans spend less time filling out paperwork and more time seeing their patients,” Secretary Sebelius said in a press release.

Currently, when a health care provider bills a health plan, that plan may use a wide range of different identifiers that do not have a standard format. As a result, health care providers run into a number of time-consuming problems, such as misrouting of transactions, rejection of transactions due to insurance identification errors, and difficulty determining patient eligibility. The change will greatly simplify these processes, according to HHS.

Commercial and government health plans are expected to spend $650 million to $1.3 billion obtaining HPIDs, the department said. However, there is expected to be $1.3 to 6 billion in expected savings over the next 10 years to providers and health plans.

To read the final rule, which will be published in the Federal Register on Sept. 5, click here.


© 2012 Beacon Health, a division of HCPro, Inc. All rights reserved.

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