The future of diagnosis coding

The Centers for Medicare & Medicaid Services (CMS) announced the future of diagnosis coding for physicians last week.  Specifically, on Jan. 16, CMS published a final rule specifying that by Oct. 1, 2013, the International Classification of Diseases, 10^th Edition, Clinical Modification (ICD-10) must be used to report health care diagnoses.

The good news is that you have almost five years to get ready, which is two years longer than CMS originally proposed.  The bad news is that you will still have to make systems changes and train yourself and your staff to use the new codes.

In the meantime, you and your practice will also have to comply with an updated X12 standard, Version 5010, for certain electronic health care transactions, including claims, remittance advice, eligibility inquiries, referral authorization, and other administrative transactions.  Version 5010 accommodates the use of the ICD-10 code sets, which are not supported by Version 4010/4010A1, the current X12 standard.  The compliance deadline is Jan. 1, 2012 – thankfully, 21 months later than CMS originally proposed.  For more information on both the Version 5010 and ICD-10 rules, you can access a fact sheet on the CMS web site.

They say that “forewarned is forearmed.”  Please consider yourself “forewarned” and anticipate that Family Practice Management, the American Academy of Family Physicians, and others will help you “forearm” as the compliance dates mentioned above get closer.