Step: 1 Make a Plan
- Assign target dates for completing steps outlined here
- Most important, obtain access to ICD-10 codes. The codes are available from many sources and in many formats:
- Code books
- CD/DVD and other digital media
- Online (e.g., go to cms.gov/ICD10 and select “2016 ICD-10-CM and GEMS” to download 2016 Code Tables and Index)
- Practice management systems
- Electronic health record (EHR) products
- Smartphone apps
- Decide role(s) your clearinghouse(s) will play in your transition. Some providers who are not ready could benefit from contracting with a clearinghouse to submit claims:
- Clearinghouses can help by:
- Identifying problems that lead to claims being rejected
- Providing guidance about how to fix rejected claims (e.g., more or different data need to be included)
- Clearinghouses cannot help you code in ICD-10 codes unless they offer third-party billing/coding services
- You must use:
- ICD-10 codes for all services provided on or after October 1
- ICD-9 codes for all services provided before October 1
- Identify everywhere in your practice that you use ICD-9 codes to make sure you know what processes and systems need to be updated for ICD-10; for example:
- Patient registration and scheduling
- Clinical documentation/health records
- Referrals and authorizations
- Order entry
- Coding
- Billing
- Reporting and analysis
- Even clearinghouses that offer coding and billing services cannot translate ICD-9 codes to ICD-10 codes unless they have the detailed clinical documentation required to select the right code
- Practices that do not prepare for ICD-10 risk disruptions in cash flow
- For a more in-depth approach to planning, see the Action Plan section of the Road to 10
To learn more about getting ready, visit cms.gov/ICD10 for free resources including the Road to 10 tool designed especially for small and rural practices, but useful for all health care professionals.
