Skip to main content

ICD - 9 to ICD 10

ICD-9 to ICD – 10
CMS Version 5010
These two transitions will require system and business changes throughout the health care industry. ICD-10 will affect coding for everyone covered by the Health Insurance Portability and Accountability Act (HIPAA), not just those who submit Medicare claims.
According to CMS effective October 1,2013
US Health care industry need to change ICD-9 to ICD – 10 for medical diagnosis and inpatient procedure codingLinks to CMS Version 5010 information
These two transitions will require system and business changes throughout the health care industry. ICD-10 will affect coding for everyone covered by the Health Insurance Portability and Accountability Act (HIPAA), not just those who submit Medicare claims.
According to CMS effective October 1,2013
US Health care industry need to change ICD-9 to ICD – 10 for medical diagnosis and inpatient procedure coding
Links to CMS Version 5010 information
  About the ICD-10 Transition on October 1, 2013
ICD-10 codes must be used on all HIPAA transactions, including outpatient claims with dates of service, and inpatient claims with dates of discharge on and after October 1, 2013. Otherwise, your claims and other transactions may be rejected, and you will need to resubmit them with the ICD-10 codes. This could result in delays and may impact your reimbursements, so it is important to start now to prepare for the changeover to ICD-10 codes.
This change does not affect CPT coding for outpatient procedures.
Version 5010
Version 5010 is the new version of the X12 standards for HIPAA transactions; version D.0 is the new version of the National Council for Prescription Drug Program (NCPDP) standards for pharmacy and supplier transactions; and version 3.0 is a new NCPDP standard for Medicaid pharmacy subrogation.
January 1st 2012, version 4010/4010A1 to Version 5010, this electronic transaction include functions like
Claims
Eligibility inquiries
Remittance advice
Unlike the older version, version 5010 will accept ICD-10, the version change will occur well before October 1, 2013

 

Comments

Post a Comment

Popular posts from this blog

What is QMB / MQMB stands for?

In Medical billing or Healthcare industry The term QMB stands for Qualified Medicare Beneficiary & MQMB stands for Medicare Qualified Medicare Beneficiary. The term "QMB" or "MQMB" on the form indicates the client is a Qualified Medicare  Beneficiary (QMB) or a Medicaid Qualified Medicare Beneficiary (MQMB). The Medicare Catastrophic Coverage Act of 1988 requires Medicare premiums, deductibles, and coinsurance payments to be paid for individuals who meet the following criteria:  Important: Clients limited to QMB are not eligible for THSteps or THSteps-CCP Medicaid benefits.  Note: Clients eligible for STAR+PLUS who have Medicare and Medicaid are MQMBs. Medicaid reimburses for the coinsurance and deductibles as well as Medicaid-only services for the MQMB client. QMBs do not receive Medicaid benefits other than Medicare deductible and coinsurance liabilities. MQMBs do qualify for Medicaid benefits not covered by Medicare in addition ...
7 comments
Read more

Key Performance Indicators (KPIs) for Successful Revenue Cycle Management (RCM) in Healthcare Organizations

 Revenue Cycle Management (RCM) is an essential process for healthcare organizations to ensure that they receive timely and accurate payments for the services they provide. Here are some of the key performance indicators (KPIs) metrics that healthcare organizations should track as part of their RCM process: Gross Collection Rate (GCR): This metric measures the percentage of charges that a healthcare organization collects from patients and insurance companies. It is calculated by dividing the total payments received by the total charges billed. Net Collection Rate (NCR): The NCR measures the percentage of expected payments received by the healthcare organization after accounting for contractual adjustments, bad debts, and other adjustments. It is calculated by dividing the total payments received by the total expected payments. Days in Accounts Receivable (DAR): This metric measures the average number of days it takes fo...
Post a Comment
Read more

Rejection Procedure note qualifier is missing

  Need to check the Charges tab and double click on the Procedure Code line to open up the Charge Entry window. There is a Notes section on the right hand side. If there is a note typed, we need to select the type.   Need to select field and select the appropriate type of note you are sending.   Save the changes made   Check all the procedure if submitted many procedure.   Save the visit again and submit the claim.
Post a Comment
Read more