ICD-10 – Staying In Front of the Deadline

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You’ve heard the buzz, ICD-10 will be delayed a year now that President Obama has signed the bill. At Netsmart, we believe the delay to ICD-10 implementation simply forestalls the inevitable. All current activities from Accountable Care, Meaningful Use, and Mental Health Parity are based upon a shift from pay-for-quantity to pay-for-quality.

The granular nature of ICD-10 is critical to the success of this shift.  If you have questions about the delay, be sure to read our FAQs. Our leading clients are already deploying, or about to start with the deployment, (more than 100 to date) and we are encouraging everyone to get started with ICD-10 sooner than later. Our advice to our clients is to get on the Netsmart ICD-10 schedule by no later than June 30, 2014.

The CMS has produced a video on the difference between ICD-9 and 10. 

Our focus is unwavering: To provide clients with ICD-10 compliant solutions in a cost-effective way and well in front of the deadline. There is only one outcome: Every client who bills services under ICD-9 diagnoses today must be able to bill under ICD-10 by the mandated deadline. From an ability to bill perspective, we’re all over that – and it’s easy to declare you can bill with ICD-10 in all of our solutions. But it is more than the ability to bill, it’s about the optimization of billing. The shift from 16,000 codes to 68,000 codes is a major change. Selection of the wrong codes will compromise your revenue. The third most reimbursement-lowering impact across nearly all DRGs with ICD-10, after malignant hypertension and uncontrolled diabetes, concerns ICD-9 codes 296.20 major depressive affective disorder, single episode, unspecified and 311 depressive disorder, not elsewhere classified. Your clinicians/coders need time to learn the new process and codes.

Upgrading now provides them that time.

The U.S. remains the only country yet to adopt the standard; its adoption is imperative if the behavioral health community ever expects to be integrated at a parity level with primary care. And, its level of detail is critical for the development of care plans that make a difference for people with mental illness. Because of this, all of us embrace the change and believe it will make a difference in the lives of the people you serve.