To help agencies prepare for the industry transition to ICD-10, a new feature has been implemented within Enterprise Edition to give users the ability to test with ICD-10 codes prior to the deadline. This new functionality has been focalized into a distinct field, ICD10 Begin, which is nested near the bottom of the page at Master Files | Payors / Plans | Payors.
Details regarding the specific functionality of the ICD10 Begin field are listed below:
● Allows users to override the System Control Date of 10/1/2015 (default ICD-10 implementation date), at an individual Payer level, for the following two reasons:
o Creation or submission of test claims prior to 10/1/2015.
o If a specific Payer indicates that they will not be ready to accept ICD-10 claims as of 10/1/2015.
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The System Control Date is a built-in feature that will automatically trigger the software to start using the appropriate ICD-10 codes to update claims as of 10/1/2015. This reduces any additional steps or preparation for agencies and will result in a smoother transition to ICD-10. If a payer will not begin using ICD-10 codes on 10/1/2015, they must enter the future date that they will begin using these codes (e.g. 12/31/2016) or the software will refer to the System Control Date of 10/1/2015. |
● ICD10 Begin field will use the following criteria:
o Date override only applies to the selected Payer plan.
o The software will continue to use ICD-9 code data until a claim reaches the date specified in the ICD10 Begin field (for the selected Payer).
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For testing purposes, users must enter a Batch Date after the date entered in the ICD10 Begin field (e.g. If a user enters "5/1/2015" then the Batch Date must be after 5/1/2015 for ICD-10 codes to show on the claims). |
o Other than the Hospice NOE (printed on UB04), the ICD10 Begin date will only affect claims. All other items will look at the System Control Date of 10/1/2015.
o Billing Warning – If an ICD10 Begin date is entered and there are no ICD-10 codes within claims, errors will be generated since there is no data to use (Error detailed in the image below can be found in Master Files | Payors / Plans | Payor Billing Errors).
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After the batching process is complete (for batches used in testing), it is extremely important that, after testing is complete, users remove any values from the ICD10 Begin field or regular claims will contain incorrect ICD codes. |
● Cropped screenshots of two sample reports (UGB04 and 1500, respectively), with ICD-10 codes displayed instead of ICD-9 codes, can be seen in the images below.
