As many providers will already attest, it's plenty challenging to adopt new chiropractic EHR software to ensure compliance with federal ICD-10 regulations. After all, learning tens of thousands of new diagnostic codes is no easy feat, especially when balancing that venture with ICD-9 dual-coding and all of the responsibilities a clinic faces in its typical day-to-day workflow. But compounding the difficulty of the issue is that, outside of what the federal Centers for Medicare & Medicaid Services (CMS) has mandated, each state has its own set of compliance rules and schedules. Consequently, some states are further ahead — or further behind — in ICD-10 readiness than others.
"State action is necessary to address ICD-10 requirements, otherwise, hospitals and physician practices will be faced with conflicting requirements to report both ICD-9 and ICD-10 on different types of bills," writes Sherry Wilson and Tina Greene for industry news source ICD10monitor. "Payers will be forced to use one set of codes to satisfy state billing requirements and a different set of codes to meet federal CMS reporting requirements."
As the authors note, states that lag behind in ICD-10 preparations can significantly disrupt coding, billing and payment continuity for providers, creating a snowball effect of logistical and financial headaches for countless clinics and practices.
To determine whether or not your state will be up to speed and ICD-10 compliant in time for next year's October 1 deadline, Wilson and Greene suggest asking the following questions:
- Does the state have a specific cut-off date for when providers will have to suspend ICD-9 use?
- If the state does not adopt ICD-10, what contingency plan(s) will be available for stakeholders to prevent disrupted workflow?
- What contingency plan(s) will be made available for those stakeholders that do not adopt ICD-10 in time?
- Will bills submitted following the October 1, 2015, deadline still be allowed to include ICD-9 codes?
- Will ICD-9 coding during this transition period still be processed? Would this dual-coding still count as a form of compliance?
- Will there be new state rules required for ICD-10 adoption? And if so, what kind of timeline can stakeholders expect to ensure financial continuity during the transition?
Ensuring that states are all on the same page with each other and federal CMS guidelines will help prevent coding and diagnosis conflicts, remove the need for providers to work with two separate sets of codes and standardize EHR data for greater cross-platform sharing.
With the best chiropractic EHR software, physicians and their staff can better guarantee that their practice will be compliant with ICD-10's coding needs.