MARCH NEWS
ICD-10 CM is on everyone's mind. Here is some information and ideas to help with the apprehension about the ICD-10-CM and DSM-5 changes for Mental Health Services.
First let's look at what is changing.
ICD-10-CM Coding
All codes reported on claim forms beginning October 1, 2014, will be different (These codes will have an alpha-numeric format, up to seven digits). Mental Health codes will begin with "F".
DSM-5 Diagnostic Criteria
Introduced in May, 2013, at the American Psychiatric Association's Conference in San Francisco, the DSM-5 criteria was to be adopted by providers upon release. Most payers addressed and mandated the changes to the new format effective January 1, 2014. So this means that provider documentation should no longer contain the multi-axis diagnosis headers. Most providers know the changes have happened and many have purchased the DSM-5 books. There is widespread confusion as to the implementation timeline, including many people who have told me they think DSM-5 starts in October of 2014. A big problem I have observed revolves around EHR software programs. Most have not adopted the necessary changes required to make this a smooth transition. If you're working with a vendor who is on track with all the changes I would love to hear about the success. I have seen timelines of late 2014 before these issues will be addressed.
New CMS-1500 Outpatient Claim Form
The new form now has a place for 12 diagnosis codes. The ability to identify different relational providers (attending, referring and supervising providers) is a critical part of the new format. Another change includes a way to accommodate Workers Compensation and auto and personal liability diagnosis codes, since these carriers are not required to follow HIPAA rules. These state requirements can require continued use of ICD-9-CM after October 1, 2014.
With so many things that are changing, testing your claims processing procedures is important. Be sure your company has a plan. Training is critical so your providers can be informed. Watching and adapting to claims issues will be important to success. Providers will need critical feedback. Having a professional examine the process for risks can help you see problems early. One thing to keep in mind is that you can do everything the industry is recommending and still experience failures.
In March, 2014, the AAPC newsletter,
Healthcare Business Monthly,
published these numbers: 9,000, 1009 and 303. They wanted the industry to remember something important about the upcoming changes. Failures should be expected with such an extensive set of changes.
- 9,000 was the number of times Thomas Edison tried and failed before the light bulb was eventually created.
- 1009 was the number of times Colonel Sanders, at 65, had been told "no" before he finally franchised KFC.
- 303 was the number of times Walt Disney failed before Disneyland was financed.
Let these numbers serve as a reminder that sometimes change is hard to implement. Stay the course and in the end your organization will succeed.
Keep in mind that our organization has lots of ways to help, including onsite training, documentation tools, auditing resources and compliance plans. You don't have to go at it alone if you are in need of help. Send me an email at [email protected]. Let's find ways to work together.
