Tuesday, May 26, 2015

ICD-10 SNF Implementation Coming Soon!

Dianne De La Mare

Diagnostic coding plays an important role in every health care setting, including long term care centers. Today, in a skilled nursing facility (SNF), providers capture and update a resident’s clinical condition on the Minimum Data Set (MDS) using the International Classification of Diseases, Ninth Revision (ICD-9); but that will soon change. On October 1, 2015, SNFs will be required to use International Classification of Diseases, Tenth Revision (ICD-10).

Implementation is challenging for SNF staff because they must learn new ICD-10 coding (which is significantly different from ICD-9 coding) to ensure appropriate billing and reimbursement. This will require SNF leadership (either at the facility or corporate office levels) to train the staff responsible for implementing rules and regulations for proper coding. At different intervals (resident discharge, transfer or expiration), staff are required to reevaluate and update ICD-10 codes (particularly for long-stay residents). All diagnoses that affect the residents care must be coded appropriately. SNFs also should consider that in an era of heightened focus on fraud and abuse, federal regulators may in the future look more closely at ensuring that the ICD-10 coding on the MDS is correct.

SNFs can conduct acknowledgement testing with CMS at any time, and providers should take advantage of the opportunity to submit claims with ICD-10 codes to the Medicare Fee-For-Service (FFS) claims systems and receive electronic acknowledgements, confirming that the claims were accepted. Although this can be time consuming, it will facilitate a smoother transition on the October 1, 2015, deadline.

CMS has provided ICD-10 training sessions to assist hospitals and physician practices; but it has not included training specific to SNFs. To assist SNFs in preparing for a successful implementation, AHCA sells 3 publications: ICD-10-CM 2014 Edition, ICD-10 Essentials for Long- Term Care: Your Guide to Preparation and Implementation, and ICD-10 Coding for Long-Term Care. To access these materials go to the AHCA/NCAL bookstore and search for “ICD-10.” AHCA has archived 2 webinars, with HCPro expert, Diane Brown. To access the webinars go to the AHCA/NCAL webinar page and type in the titles listed “Are you Ready?” or “Is Your ICD-10 Coding Accurate.”

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