An Update on ICD-10: What You Need to Know

Remember when the acronym “Y2K” evoked fear and trembling in computer programmers? Today, “ICD-10” is having a similar effect on those of us who work in the business of healthcare.

On October 1, 2014 , the industry will shift to ICD-10, the 10th edition of the International Classification of Diseases (ICD). ICD-10 is vastly different from ICD-9; it expands the number of available codes from 24,000 to 155,000 . The intention of the expansion is to improve patient care through the offering of more specific, accurate codes for diseases that can be shared throughout our healthcare system.

Where do you stand on ICD-10 preparedness?
If that question evokes aforementioned fear and trembling, you’re not alone. Sure, you’re not alone in the sense that all providers and payers are also facing the daunting changes that ICD-10 requires. We’re working to help you prepare for the October 1st of 2014 compliance date.

Rest assured, we’re focused on doing all we can to help you get prepared and avoid losing reimbursements in the vortex of noncompliance.

Here are specific ways Emdeon is on the case:
• We’ve devoted expert, multi-disciplinary staff and resources to ICD-10. Not only do we have an Executive Steering Committee to oversee ICD-10, but we also have a Functional Steering Committee comprised of leaders across our organization to ensure a synergistic approach across all impacted areas. Under the guidance of these leadership bodies, we have an ICD-10 Program Office Team facilitating day-to-day activities and delivering educational materials for our customers.

• We have readiness materials available for your reference; access them by clicking here: These quick-read documents are handy for pinpointing key changes, deadlines and other information relevant to your organization.

• We have a stated, specific timeframe for testing and implementation, and we’re not selling a tool kit for compliance. All the efforts and resources we’re devoting to ICD-10 are offered to our customers and partners at no additional charge. We consider our preparedness and our support for your preparedness an extension of our services and part of our leadership role within the industry, not an opportunity to generate revenue in your hour of need.

• We’re on target to provide a standard testing exchange by the third quarter of this year. The most common questions that customers ask us relate to how and when they can test transactions, so our expedited timeframe for offering a testing platform is welcome news. The standard testing exchange creates a pathway for providers to send us test codes and receive clearinghouse feedback that confirms whether or not the claims are valid. The testing process will be manual, but it will be immensely helpful and illuminating to participants preparing for the compliance date.

• We will store and share testing findings with providers. As an extension of our testing, we will be storing information found and sharing that data with payers to aid them in preparedness, as well. This kind of feedback will be very helpful for payers as they get up to speed.

• We will create full testing transaction and claims scenarios for providers and payers. In accordance with our predefined compliance timeline, we are on track to work with all entities to test claims submissions, transmittance through Emdeon’s system, payer pick-up and payment systems. At this level of testing, we’ll identify concerns and make modifications as needed.

• We have developed statements and strategies for handling a range of scenarios post-compliance date. For ICD-9 coded claims sent after the compliance date, our goal is to not stymie such claims from reaching payers but rather to pass them so that payers may make the determination whether to apply rejections. In those cases, we will apply rejection messaging so that providers know the payers require ICD-10 in order to adjudicate the claims. This is just one of a range of specific tactics we’ll be ready to implement to help providers and payers flesh out a full transition.

Just as this is a priority for you and your team, it’s a priority for us, as well. If you need more details about our testing processes or other ICD-10 approaches, contact us today! Or visit us online to learn more.

Bookmark and Share