Dear Valued Provider and Office Staff:
The mandated transition to ICD-10 represents one of the biggest challenges in
health care history, as the change is far-reaching and affects a number of
entities in the health care industry. Increasing the number of codes from
approximately 24,000 ICD-9 codes to over 140,000 new ICD-10 codes will not be
an easy task and will require significant upgrades to systems and processes for
payers and providers. Therefore, it is important that preparation begin now to
comply with the mandated ICD-10 implementation date of October 1, 2013.
Beyond the ability to diagnose diseases on a more granular level, increasing
the number of diagnosis codes has many additional benefits for providers,
including reducing payment errors, speeding up the reimbursement process
throughout the industry, and the possibility of enhancing quality measurement
and research to inform changes in health care.
A number of negative scenarios could potentially affect the workflow of
providers who are not prepared to
implement ICD-10 codes by October 1, 2013. Examples include:
rejection of claims payments;
coding and billing backlogs;
inaccurate/incomplete clinical metrics and pay-for-performance reporting that
does not meet peer standards.
Providers can prepare for the transition and avoid being negatively affected by
taking inventory of changes required at their practice, such as evaluating
business and IT efforts that are involved (e.g., required upgrades to practice
management software). The Centers for Medicare & Medicaid Services (CMS) have
established recommended timelines for small and large provider offices to
comply with the ICD-10 implementation date of October 1, 2013. Visit
www.cms.gov/ICD10/03_ICD-10andVersion5010ComplianceTimelines.asp to review the
CMS timelines. Providers are encouraged to use these timelines to gauge their
readiness level.
AmeriHealth is committed to sharing information with providers about the
mandatory transition to the ICD-10 code sets. As part of that effort, we will
continue to publish articles in upcoming editions of Partners in Health Update
that focus on various transition-related requirements and our plans to comply
with the mandated transition. Providers can also find information about the
ICD-10 transition by visiting www.amerihealth.com/icd10. If you have any
questions about our transition to ICD-10, please email them to
ICD10@amerihealth.com.
Thank you for your participation in our network and your efforts to prepare for
this transition.
Sincerely,
Ronald J. Brooks, M.D. Steven J. Brown, M.D. Lisa Blondin, M.D.
Senior Medical Director Medical Director Medical Director
AmeriHealth (Pennsylvania) AmeriHealth (Delaware) AmeriHealth New
Jersey