CMS To Provide Medical Billing Software Well In Advance

Published on by John Mathews


The Centers for Medicare & Medicaid Services have announced that EHR providers will receive the required coding and billing software six months in advance. This gives providers double the lead-time that was required for the planned ICD 10 transition, which is delayed by almost a year. The agency has also mentioned that it will carry out several additional outreach programs in the upcoming months and will encourage providers to make the best of the lead-time in order to prepare their system for the coming changes. ICD 10 codes have the provision to encode a larger number of diseases (68,000 existing codes, as opposed to the 13,000 in ICD-9). Moreover, the new code system has been changed from the existing one in order to handle a greater set of specificity, which means a single code of seven-digit alphanumeric code is now able to convey more information than the earlier ICD-9 code.

ICD-9 coding scheme has been use for over 40 years and is outdated to say the least. The ICD 10 transition was supposed to come into effect on Oct. 1, 2014. However, the dates have been postponed for exactly a year, that is, Oct 1, 2015. Long-term medical care providers have been preparing for the switch to the new system for several years. The new system of codes has undergone a major expansion centering on specificity.

A large number of workers in medical institutions were required to start the training in order to incorporate the new set of medical codes and corresponding changes in medical coding and billing. The delay in the ICD 10 transition will give these employees extra time to prepare and will help institutions which are behind schedule to come up to par with the rest.

The additional lead-time came into effect because “several commenters” pushed for it and requested CMS to increase the time. The reason behind postponement came into light after the agency issued a final rule on Oct. 30, 2014. Tracking the progress of various hospitals and other medical institutions, medical service providers were getting increasingly anxious about the viability of complete transition. Moreover, some sources even mentioned that CMS was not giving the help required for ICD 10 transition.

In order to appease the providers and ensure safe and secure transition, CMS has stated that it will carry out several outreach programs and will encourage providers in taking full advantage of the additional lead-time to prepare their systems and submit to using ICD 10 codes.

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