CMS is making some changes to the ICD-10-CM codes, effective October 1, 2016. In some cases, CMS added new codes and retired others. In other cases, only the description associated with the code changed.
Although these changes are not nearly as sweeping as the transition from ICD-9 to ICD-10 last year, there are some similarities:
October 1 is the so-called “cutover date.” The updated codes apply only to claims with a service date of October 1 or later. Claims with a service date of September 30 or earlier will continue to use the current codes.
Eyefinity has your back. We’re currently updating Eyefinity EHR and ExamWRITER to properly code your exams based on the selections you make during the exam and the date of service. In other words, keep coding the way you always have, and we’ll take care of the rest. We’re also updating the ICD-10 codes in our practice management systems for billing and reporting.
Billers should familiarize themselves with the changes. Billers should be prepared to verify that the correct codes are appearing on claims
Eyefinity has identified over 400 ICD-10 changes that apply to eyecare. Code changes to the following areas take effect on October 1, 2016:
Retinal vein occlusion
Age-related macular degeneration
Primary open-angle glaucoma
Postprocedural hematoma or seroma
We anticipate that CMS will modify ICD-10 codes slightly every year.
We’re adding the ICD-10 changes to OfficeMate/ExamWRITER now, which will be available in a service pack in September. You’ll need to download and install the service pack before October 1 to avoid any disruption in billing.
Eyefinity EHR, Eyefinity Practice Management, and AcuityLogic updates are scheduled in September and will include all of the ICD-10 updates.
The transition to ICD-10 is now just weeks away. Hopefully, you have already upgraded your practice management and electronic health records systems. If you’re an OfficeMate/ExamWRITER user, you need to be running version 12; if you haven’t downloaded it yet, you can do so now on MyInstallCenter. If you’re an Eyefinity Practice Management, Eyefinity EHR, or AcuityLogic user, you’re good to go—there aren’t any upgrades that you need to complete!
Once you’re using updated software, nearly everyone from CMS to the AOA is encouraging you to work with your insurance clearinghouse or insurance carriers and send them test insurance claims with ICD-10 codes. Submitting test insurance claims that contain ICD-10 codes will give you practice in using ICD-10 codes; help you work out any transition quirks with your clearinghouse or carriers before the deadline; and, hopefully, instill confidence in your office’s ability to submit insurance claims and get paid after October 1.
Your insurance clearinghouse or insurance carriers should have provided you with ICD-10 testing information; if they haven’t, contact them.
Remember that if you are using OfficeMate/ExamWRITER 12, you can change the ICD-10 start date for individual insurance carriers, making it easy for you to send test data with ICD-10 codes to carriers. For additional help in preparing for and testing before October 1, review the OfficeMate/ExamWRITER ICD-10 Readiness Checklist and view the step-by-step instructions in the Eyefinity Support Community. If you’re using Eyefinity EHR, Eyefinity Practice Management, or AcuityLogic, review the material in the Eyefinity ICD-10 Resource Center for information on sending test data with ICD-10 codes to carriers.
Test now. The transition to ICD-10 is right around the corner.
Maintaining your car, home, appliances, and personal health is important to ensure optimal performance. Your software is no different! Are you protected from computer security risks? Is your technology allowing you to run a profitable business while delivering a great customer experience?
If you are using Eyefinity Practice Management or Eyefinity EHR, you don’t have to worry about software updates. Being “in the cloud” means Eyefinity maintains your software, ensuring that you are always using the most up-to-date version of your cloud-based software.
If you are using one of our on-premises solutions, like OfficeMate/ExamWRITER, then you need to download and install the newest software update, OfficeMate/ExamWRITER 12.0. This version will prepare you for ICD-10. It’s a great idea to download and install this version by July 2015, so that you are prepared for the government’s ICD-10 cut over well before the October 1, 2015, deadline.
Keeping up to date with software partner patches is also important. For Example, if you are using the ExamWRITER ePrescribing Interface, there is an update that needs to be installed by June 30, 2015. Partners like DrFirst, make changes to upgrade their functionality which can impact the eprescribing integration with ExamWRITER. Small patch updates only take a few minutes to download and run and are important in preventing interruptions in services you depend on.
We all agree that there are benefits to be gained from the 30K, 60K, and 100K mile car tune ups. Annual physical and optometric exams are something you recommend to your own patients. Don’t forget about the importance of maintaining your software, too!
Early adopters are on the “leading edge” of change, but there are also those on the “bleeding edge” of change. We all know colleagues who moved into early electronic medical records years ago and are now on their second or third system. As a large practice, we didn’t want to fall into this scenario because it means having to deal with multiple episodes of pain associated with major system changes. Our goal was to do it once and do it right.
So, we have waited, watching for technology that will meet our practice needs, and looking for a solution that can fully integrate a PMS and an EHR. Until recently, the only reliable choice for PMS/EHR solutions were on-premises server-based systems, built around Windows-based programming. The cost of the hardware, combined with the dependency of the doctor to use a keyboard in the exam room, were major obstacles. Thankfully, with the industry moving into cloud-based and iPad-compatible systems, these barriers have been dramatically reduced.
With just under six months left to make changes before the ICD-10 cutover, we’ve chosen the Eyefinity cloud platform. The iPad application allows us the flexibility that we need to manage our large practice. The auto-coding capabilities of the system will make us ICD-10 compliant. And, we’ll be able to increase our efficiencies and bottom line. We’re confident that Eyefinity’s solutions will provide best-in-class technology and allow us to meet our ICD-10 deadline.
My practice, like many others, has taken a “wait and see” approach to preparing for the ICD-10 transition. Optometrists, in general, are often slow to make major changes in their practices unless significant impacts to our income are recognized. This goes in both directions: dollars out and dollars in.
Most doctors carry a number in their heads that’s in the tens of thousands of dollars to upgrade or convert to a practice management system (PMS) and electronic health record (EHR) that will make their practice ICD-10 compliant. That’s a hard pill to swallow. So, we avoid this major expense for as long as possible. We continue with “business as usual” for as long as we can.
Unfortunately, because the ICD-10 changes will affect every aspect of our office flow, we can’t procrastinate any longer. Come October 1, 2015, if we don’t have a solution in place and we are not billing ICD-10 codes, we will not be able to collect reimbursements from third party payers. Everyone needs a plan and needs to put it into place now! Our practice chose to work with Eyefinity as our ICD-10 compliant solution because their cloud-based system dramatically reduces our costs of implementation. And, the auto-coding capabilities of the system will not only make it easy for us to use ICD-10 codes, but also increase our efficiencies and bottom line.
As a private practicing optometrist, it seems like there are more and more pressures being applied on how we run our practices. One of the biggest looming pressures has been the implementation of ICD-10 codes. We’ve heard about this massive change in how we will have to bill and code our patient visits for several years. We’ve also heard all of the horror stories of how much more complex this system will be, as compared to the ICD-9 coding system that we’ve become accustomed to.
Our practices received a little breathing room last year, when the mandatory implementation of ICD-10 codes was delayed. But, despite the continued turbulence in Washington D.C. around health care administration, the senate passed H.R.2 April 14 without an amendment to postpone the ICD-10 cutover date. So, it looks like October 1, 2015, is a hard deadline for providers to start using ICD-10 codes. That gives us just under six months left to implement a solution for billing ICD-10 codes in our practice. Do you have a plan?
All Eyefinity products either are or will soon be ready for the ICD-10 transition. Go to the Eyefinity ICD-10 Resource Center to determine if you need to upgrade your on-premises software, or, if you’re already using an Eyefinity cloud product, when your software will automatically update with ICD-10 changes. Not on the cloud, but want to be? Eyefinity has a plan for that, too!
The entire medical industry is aflutter with ICD-10 news, tips, dates, codes, documents, and even a funny comment or two about some of the new codes (W56.22xA – Struck by orca, initial encounter?!). But really, the information that you need most is answers to these two questions:
What are the exact things that I need to do to prepare for the October 1, 2015, cutover date?
What are the exact things that I need to do in order to bill using the new ICD-10 codes?
If you are using OfficeMate/ExamWRITER and plan to upgrade to version 12.0 so that you can bill ICD-10 codes, we have created a short checklist that will help guide you through the ICD-10 transition. It boils down to this:
Before you upgrade to version 12.0:
Finalize all of your open exams in ExamWRITER.
After you upgrade to version 12.0:
Ensure that you have set up your personal ExamWRITER preferences.
Update any custom templates and clinical decision support templates that you created in ExamWRITER that contain ICD-9 codes.
Ensure that your office location address is complete (i.e., mailing address and nine-digit ZIP code) in OfficeMate Administration.
Determine when you want to begin submitting ICD-10 codes, if it’s not going to be on October 1, 2015.
Before the October 1, 2015, Cutover Deadline:
Record all of your fee slips that are on hold in OfficeMate.
Process all of your open insurance claims in OfficeMate.
After the October 1, 2015, Cutover Deadline:
Document exams in ExamWRITER as you have always done, selecting eye lateralities and then diagnoses. Yes – it’s that easy!
There is no step 2! ExamWRITER will automatically code your exams, based on your exam selections, and transfer the codes to OfficeMate fee slips.
Transitioning to using ICD-10 codes may sound daunting, but if you’re using OfficeMate/ExamWRITER 12.0, you are ready!