In the past, our skilled nursing world has revolved around a sun of its own, known as resource utilization groups (particularly the lucrative high-therapy ones). Now, however, according to the details of the new Medicare fee-for-service reimbursement model known as the Patient Driven Payment Model (PDPM), it seems that we’ll soon be revolving around a different sun altogether: ICD-10 codes.
It was just about a month ago that providers transitioned to the International Classification of Diseases, 10th Revision – ICD-10. While the early reviews have been decidedly mixed, one thing is for sure: weird and obscure was never like this.
Providers who cannot generate ICD-10-compliant claims by October 1, 2015, will see those claims returned for correction, which will mean delayed reimbursement for services provided, ultimately affecting that organization’s bottom line.
The Centers for Medicare & Medicaid Services announced it will work with the American Medical Association to ease the transition to ICD-10, including a 12-month grace period when claims won’t be denied for unintentional code errors.
Despite two delays and a host of costly implementation issues over the past year, most healthcare providers will likely make a successful transition to the 10th round of ICD codes, a General Accountability Office report has concluded.
As providers get back into gear for the ICD-10 changes to hit in 2015, researchers at the University of Illinois at Chicago have developed a free online tool to help healthcare facilities determine where more time and effort will be needed to prepare for the transition.
Providers will receive needed coding and billing software six months before the ICD-10 transition date, the Centers for Medicare & Medicaid Services has announced. This is double the lead time that providers had for a planned 2014 transition, which was delayed by a year.
There’s a looming massive report on all the hospital readmissions data in your area and the strategic plan your facility needs to pursue. It involves talking to lots of employees, gathering data, doing statistics and the actual writing, not to mention proofreading, and having your boss sign off on it. It’s due Oct. 15.