While the day of reckoning has arrived, and all medical billing service providers have promptly embraced ICD-10 codes, the question that comes to the fore is what happens to ICD-9 codes now. Well, you must be thinking it is now a matter of past. But ICD-9 is anything but dead and buried. This coding system will still have a place in US healthcare post the October 1st deadline. Yes, as per CMS every healthcare entity that is covered by the HIPPA act of 1996 must adhere to the new ICD-10 standards and record every single date of service, or date of discharge for inpatients, that occur on or after October 1, 2015. But this mandate doesn’t cover just about every medical service provider and payer in the country.
There are certain entities such as auto, disability and worker’s compensation insurers that do not come under this wider commandment and hence are not required to switch. And this means that healthcare providers have to still use ICD-9 codes for claims related to disability income, automobile medical payment, worker compensation and other similar insurance coverage under which the benefits of medical care are incidental or secondary in nature, as per HIPPA.
Generally, if the non-covered entity wants to use ICD-9 codes, they can continue to do so unless mandated by law, just like in the case of worker’s compensation insurance. This insurance is regulated by the state and medical practices cannot opt to use ICD-9 codes if the state demands ICD-10 codes for even non-covered claims.
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Also, it is worth mentioning that the continued use of ICD-9 codes will add to the complication of using codes in the industry. For instance consider the states such as South Carolina, Maine and Indiana. These states have made it mandatory to use ICD-10 codes for hospital inpatient billing only. What this means is that healthcare practices have to use old medical coding system for workers compensation claims and new coding system for everything else. This is not an ideal scenario for healthcare providers, as they would have to maintain two coding systems and cross-check with individual healthcare payers to find out how to submit their claims at all times.
Experts believe this confusion will not last forever. This is because insurance companies will soon realize the benefits of the new system and start accepting ICD-10 claims.