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    The top 10 things you need to know about ICD-10

    The change may seem intimidating, but it’s coming all the same: The new ICD-10 diagnostic code set will be implemented on October 1, 2015. The International Classification of Diseases, Clinical Modification Volume 10 (i.e. ICD-10) is required on all medical insurance claim forms. So, what do you need to know? Here are the top 10 things that will make the transition to ICD-10 a little bit easier. 

    1. Background on ICD-10

    The World Health Organization adopted this volume of diagnosis codes in 1993. ICD-10 is a much more specific code set than ICD-9, and as you become more familiar with it you will notice it feels more like a health care data statistics code set rather than a billing code set.

    2. What's changed?

    Just like in ICD-9, the diagnosis codes reported on a claim form tell the story of why you did what you did (support medical necessity). With room for 12 diagnosis codes on the new claim form, carriers are expecting you to give a complete story and how you list diagnosis codes is integral to getting the claim paid.  When filling out a claim form, the code listed in box 21 line A should be the diagnosis codes that best supports the reason “why” you performed a service.

    Remember the number one rule of diagnosis coding: We are telling the story to the carrier as to why you performed the service that you did. We are not making up a story to get a claim paid. The information listed on the claim form must be supported by the documentation in the patient’s medical record.

    Continue to page two for more...


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