10/03/2015    Joseph Borreggine, DPM

ICD-10 Panic

So, here were are hours into the ICD-10
transition. The sky has not fallen, but it might
still. "The proof will be in the pudding", as
they say. Whether we get paid on these new codes
will be up to the insurance companies that we
bill. We will see what happens over next few
weeks and months.

The warnings that we may not get paid in a timely
fashion may still occur; so be prepared for some
"expected" financial shortfalls in your revenue
stream during this transition. It is a good idea
to identify any available Local Carrier
Determination Policies (LCDs) provided by CMS
(Medicare) and any other billing nuances with
respect to to your CMS-1500 claim form required
to have a "clean claim."

I have been dual coding for the last month and
feel confident that I am prepared to use the
proper ICD-10 codes. I have listened to numerous
APMA webinars and attended numerous seminars on
ICD-10 coding which have helped immensely. My
observation is that a majority of these new codes
are a simple one-to-one transition with the added
"6th or 7th character" based on laterality, visit
presentation (initial "A", subsequent "D", or
sequela "S"), and other letters like "B-S" for
fractures, sprains, wound and ulcers. There are
other things like "exclusion" of certain
diagnosis that must not be used when using a
particular code or "inclusions" that require a
code be present when using a code.

I opine that this ICD-10 transition has been made
much simpler with the APMA ICD-10 resources (APMA
Coding Resource Center), Codingline, PM News
Magazine, Podiatric State affiliate coding
programs, and other available references on the
Internet. So, if you have done your homework,
studied the material, then you should past the
test. The grade you receive will be reflected in
either acceptance or rejection of the codes you
submit. Whether they are right or not is based on
your interpretation of what you diagnosed in your
exam, The infamous insurance "audit" is now
going to be lurking no more than ever, therefore
your documentation must match your codes
submitted.

Good luck and may the coding gods be with you
(and me)!

Joseph Borreggine, DPM, Charleston, IL

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