grace-period-over

On October 1 of this year the annual code updates will resume, and to a limited extent they will impact chiropractors.  The biggest news is that Medicare’s “grace period” is now officially over starting October 1, 2016. In case you forgot what the grace period entails, here’s the deats: you can now be audited and your claims can now be rejected based on ICD-10 coding issues. Up until now, Medicare allowed chiropractors some time to become ICD-10 proficient and claims were not audited or rejected solely based on ICD-10 problems. But now……the grace period is OVER.

In the coming months we will look at many of the individual code changes that will likely impact us and our peers. However, let me first say that this should be an easy, inexpensive transition with very few code modifications that will impact most chiropractic offices.

Here’s What You Need To Do

The process for dealing with these changes is almost identical to what we did when we switched from ICD-9 to ICD-10 on October 1, 2015. 

  1. Learn about the code changes.  I have created a cheat sheet that will capture most of the changes that will impact chiropractors.     However, you can also download the entire code set for free here: http://ow.ly/XB2Y301Fjdh.  From that page you can access the tabular list, the alphabetic index, and the “addendum” that lists all of the additions, deletions, or changes that will be made to the code set.
  2. Start making any necessary documentation changes now so that your documentation supports the new and generally more specific codes.  Many of these changes are so straight-forward that most offices will not have to significantly change their documentation protocols in order to accommodate the new codes.
  3. Ensure that these new codes will be in your EHR or practice management software by October 1. I’m sure that some vendors will add them automatically while others may require providers to enter the codes into the system manually. It is not a bad idea to check with your vendor now so that you know how to prepare as the implementation date approaches.
  4. Be aware that these 2017 ICD-10-CM codes are to be used for patient encounters occurring from October 1, 2016 through September 30, 2017.
  5. On and after October 1, select the codes based on the date of service, not based on the date the claim is sent. Claims for dates of service prior to October 1, 2016 will use the current codes regardless of when the claim is sent. Claims for dates of service after October 1, 2016 will use the new codes.