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Mental Health Billing and the ICD-10

Back in August, the U.S. Department of Health and Human Services (HHS) posted a proposed rule requiring the implementation of the portion of HIPAA that mandates use of the ICD-10 by October 2011. The International Classification of Diseases-10 was endorsed by the 43rd World Health Assembly in 1990 and was implemented by many World Health Organization (WHO) member states as early as 1994. The United States is 14 years behind the curve on use of this updated version of the ICD, the list of diagnoses used in all medical billing. As more healthcare organizations implement electronic medical records (EMRs) ICD diagnostic codes are used ever more widely, but at present payment for health services is still the most important function of these codes in the U.S.

There was an immediate outcry from provider and payer organizations that the 2011 date was too soon. The Medical Group Management Association, the American Medical Association and America’s Health Insurance Plans registered objections with HHS over the implementation date indicating that the costs would be too great for providers and payers, especially given the recently completed and very costly implementation of the NPI (National Provider Identifier).  But now, the American Hospital Association has supported the 2011 date suggesting that the potential gains from use of the ICD-10 are too great to wait any longer to implement the new codes.

We know the pain that has been experienced by customers of Synergistic Office Solutions in adopting the NPI and continuing to get paid for services rendered. Our software has been able to handle the NPI since early 2007, but some of our customers still struggle with the confusion caused by this transition.  While software can be made ready for the ICD-10 without very much difficulty, we are concerned about how this change will be handled in the real world by psychologists and psychiatrists and social workers who are accustomed to using the DSM-IV and ICD-9 for diagnoses for mental health conditions.

What do you think about a move to ICD-10? Do you expect this next round of changes required by HIPAA to be simple? to be problematic? What do you expect the impact will be for your organization and how do you plan to handle it? What is the best way for vendors of mental health billing software and medical billing software, medical EMRs and behavioral health EMRs to assist providers in implementing the new ICD-10 codes? Let us know what you think. We want to help make this new transition as smooth as possible.

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