In the lead up to ICD-10, everyone wondered what the landscape would look like once October 1st arrived and in the subsequent weeks and months to follow. Would providers be conversant enough with the correct ICD-10 codes? Would the folks at CMS be sticklers with no tolerance for coding mistakes? Would payers have their acts together on their end with regard to the code changes?
So far, according to the press, none of these concerns has reared its head and all is running pretty smoothly. CMS seems to be sticking to its promise to, as we reported in an earlier blog on the subject, not aggressively deny provider claims for simple diagnosis-coding mistakes as long as the submitted code falls within the correct family. A policy it intends to continue through the first year of ICD-10. Okay, but what about insurers?
No real trouble on this horizon for the moment, either. Forbes recently wrote that large health insurers were reporting “few problems in the early days” of the launch, specifically citing Humana and UnitedHealth Group (UNH) as examples.
According to the online article, titled Smooth Rollout For New ICD-10 Medical Codes, Insurers Say, Humana reported a mere 0.03% of provider calls being related to “benefits, claim status, spanning date of service, and authorization” related issues. The piece also quotes Humana’s ICD-10 implementation team leader Sid Hebert, who said that after ten days in almost “everyone who is submitting claims is getting it right.” Similarly, UNH reported only a “slight uptick” in denied claims.
HealthDataManagement posted a similarly titled article, ICD-10: So Far, So Good, in which the writer quotes Patrick Hall, EVP at clearinghouse e-MDs as saying “it’s been a log smoother than we thought” and that, as with Y2K in 2000, there have been fewer issues than what many had expected.
Addressing this current claim submission/reimbursement smooth sailing, RCxRules CEO Stephen Gorman said recently, “I may be overstating the obvious, but it’s likely things are going this well because of all the time, effort and preparation both payers and providers put into their readiness plans. A successful IT conversion of this size does not go well by accident. Everyone should feel good about their efforts”
However, he cautions, it may be that payers are initially being more agreeable than they might be six months from now. “It’s still early in the game,” he adds.
Whatever happens, we’ll be here to examine it and offer our perspective. We’ll see you soon.
