ICD-10 Transition: October 1, 2015

CMS continues to educate and prepare providers and vendors for the big move to ICD-10 on October 1, 2015. For behavioral health and substance abuse providers, that mostly means using ICD-10-CM codes for diagnostic purposes for all services provided after September 30, 2015. If your organization provides inpatient behavioral health services, get some guidance from your payers about the need to use ICD-10-PCS codes (procedure codes) on your claims. If you submit UB-04 claims on paper or electronically, be sure to check with your payers.ICD-10 manual image55

CMS has created lots of tools and a very detailed web site to help you transition from ICD-9 to ICD-10. You can check the CMS Latest News page regularly, or you can sign up for email updates. If you are a behavioral health provider and you know nothing about the move to ICD-10, start with the web site and tools. These will give you the greatest amount of information the most quickly. But do get started. October 1 will be here momentarily!

Most SOS customers have been in practice long enough to remember that not all changes go as well as planned. When we all made the simple change to using a National Provider Identifier (NPI), most of us could not see any reason why things might not go smoothly. Unfortunately, we were wrong.

For some payers and for some third party administrators, especially for small payers and managed care companies, the process resulted in delays in payment that had drastic effects for some of our providers. Cash flow interruptions of three to four months can devastate a business, so you must be prepared for such a possibility just in case it were to occur. If you do not have that much cash saved in your business, you might want to consider obtaining a line of credit that is large enough to get you through the transition in case one or more of your payers is not ready to make the switch to ICD-10 a seamless one.

If you are an SOS customer, check the version of SOS Office Manager that you are using. If you have a current support agreement, you are entitled to update to the version which supports the ICD-10-CM. If you do not have a current support agreement, give us a call to get a quote to update to the most current version. If you are using version 2014.01, you should see additional ICD-10 fields in your Claim Setup screens (both Professional and Institutional), and you will find the ICD-10 Prep Utility on the SOS Office Manager Tools menu. 

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