ICD-10 is here!

ICD-10 compliance means that everyone covered by the Health Insurance Portability and Accountability Act (HIPAA), and not just those who submit Medicare or Medicaid claims, must use ICD-10 codes for healthcare services provided on or after October 1, 2015.

This means that all software systems currently in use by practices that utilize ICD-9 will be required to update to support the use of ICD-10.

ICD-10 training will be required for all healthcare providers, clinical staff, coders, billing and administrators. They will also need to develop new practice policies and guidelines, and update paperwork and forms. Practices should also create cheat sheets that list their most frequently used ICD-9 codes and their ICD-10 equivalents.

Kareo understands that there will be a general industry lag in the adoption of ICD-10-CM for some non-HIPAA entities and will continue to support the use of ICD-9-CM within the system during the transition.

Kareo is actively working to support practices by providing critical preparation tools. The Most Commonly Used Diagnosis Report provides a list of a practice's most commonly used ICD-9 codes. The crosswalk can suggest potential corresponding ICD-10 codes based on this report. Our practices also have the ability to dual code, representing a diagnosis in both ICD-9 and ICD-10. And the ICD-10 Success Dashboard tracks a practice's progress toward the October 1, 2015 deadline.

The biggest impact to your practice will be cash flow since any ICD-9 codes used in transactions for services or discharges on or after October 1, 2015 will be rejected as non-compliant and the transactions will not be processed. Physicians are urged to plan for reimbursement delays and arrange for emergency funding to cover all practice expenses (overhead, staff salary, supplies, etc.) for a minimum of three months.

The good thing for our customers is that we do the testing for them! Kareo will continue testing with our clearinghouses to make sure that everything is ready for October 1, 2015. Separately, our clearinghouses have participated in payer testing with a 95% and higher success rate.

Good news, you won’t require any changes to your hardware system to support your Kareo software.

All reported issues are handled in a timely manner and, as with any other issue it will be prioritized accordingly based on the severity and impact of the reported issue.

Kareo has several tools and references available on the ICD-10 Resource Center:

• ICD-10 Small Practice Guide, a guide to help navigate through the transition
• Kareo's ICD-10 Success Checklist, a convenient, step-by-step planning tool
• ICD-10 e-books, guides by specialty, for Mental Health, Pediatrics, Primary Care, OB/GYN, and Surgery practices
• ICD-10 on-demand webinars

Kareo has partnered with ICD-10 Success to offer ICD-10 Coding Classes and ICD-10 Documentation Classes. Through our partnership, we are able to provide this resource so you can get the training you need to be successful in the transition to ICD-10.

ICD-10 Success Training Programs provide a complete ICD-10 training solution for the entire staff. Educational videos combined with interactive games, documentation templates, and crosswalks are designed so that everyone in the practice understands their role in coding effectively for ICD-10.

You can select from a variety of courses for both your coders and staff. As a Kareo customer you will receive a $5.00 credit for each documentation course. To sign up:

• Go to this link: Kareo Access link.
• Click on Click Here to Join Us box in the right hand column
• Select the courses you wish to purchase.
• Review your order in Your Cart.
• Enter the Coupon Code KAREO and recalculate by clicking Apply.
• Payment is either by PayPal or as a Guest to PayPal you can use Visa, MasterCard or American Express.
• User will receive an email when the purchase is complete.
• From the email, they will have immediate access to the course.

For a list of courses and more information, read this blog post.

Yes. ANSI 5010, CMS-1500 (02/12) and UB-04 were all designed with the idea that both versions will be needed as part of the overall transition.

Kareo provides a report to allow the practice to identify their most commonly used ICD-9 codes. Using this report and the crosswalk tool in Kareo, along with the ICD-10 Manual, you can map your top ICD-9 codes to their ICD-10 equivalents.

Kareo provides the ability to dual code without distributing workflow. At key points in the application, specifically encounter approve, superbill creation and problem lists, both the ICD-9 and ICD-10 may be viewed together.

Tools will be provided in upcoming releases to allow easy alphabetical searching for the appropriate code.

Kareo provides a report to allow the practice to identify their most commonly used ICD-9 codes. Using this report and the crosswalk tool in Kareo, along with the ICD-10 Manual, you can map your top ICD-9 codes to their ICD-10 equivalents. Tools will be provided in upcoming releases to allow easy alphabetical searching for the appropriate code.

Please note that Correct Coding Initiative (CCI) Edits will not be impacted by the ICD-10 implementation.

Actually, non-specific codes do still exist in ICD-10. The fact that ICD-10 does offer a higher level of specificity does not resolve situations where the patient's condition cannot be coded to a more specific code. The key is that the provider's documentation continues to justify the use of the non-specific code.

There are three areas that control the number of diagnosis codes that can be submitted on a claim.

• The electronic claim format
  • ANSI 5010 837P: The majority of Kareo clients utilize this claim format and it currently supports up to 12 Diagnosis Codes per claim.
  • ANSI 5010 837I Institutional: As far as our client base, this applies to Ambulatory Surgery Centers (ASC), Comprehensive Outpatient Rehabilitation Facility (CORF) and Outpatient Rehabilitation Facility (ORF).
• Paper Claim Formats
  • CMS-1500 (02/12): This new claims format allow support of up to 12 Diagnosis Codes, however, what has not changed is that each procedure will still only allow up to 4 diagnosis pointers. This means that this new form can still only support 4 diagnosis codes per procedure. If the claim has multiple procedure line items and have more than 12 unique diagnosis codes, then the claim will be split accordingly.
  • UB-04: In the current state supports capture of a primary diagnosis code and up to 17 additional diagnosis codes.
• Kareo Encounter Entry Screen
  • Professional (837P or CMS-1500): Currently only supports the entry of 4 unique diagnosis codes per line item.
  • Institutional (837I or UB-04): Supports as much as the claim format will support. Allows entry of Principal Diagnosis (required for all Institutional claims), Admitting Diagnosis (only required when a patient is admitted), “Other Diagnosis” which allows as many other diagnosis codes as the claim format will support.