How to Transition Smoothly to ICD-10

Transition to ICD-10 Smoothly

The deadline to start submitting all billing claims using the ICD-10 format is October 1st, 2015. After this date, mental health practices, along with the rest of healthcare are required to use ICD-10 codes to bill insurance companies or help clients submit claims for reimbursement. For mental health and therapy practices, there is the added complexity of DSM-IV to DSM-5 transition. You cannot submit claims using the DSM codes, and will need to convert them to the appropriate ICD codes when billing or providing a superbill to your clients for reimbursement.

The Challenge

There are nearly five times as many ICD-10 codes as the previous ICD-9 codes and tracking changes manually during this transition will be a hassle. It’s essential to have a system and process that will not impair your ability to function as a practice, while minimizing errors. Coding errors not only delay payments, they interfere with your ability to manage cash flow effectively.

The easiest way to manage this transition is by having a practice management software help you quickly adjust to using the new codes. With a therapy billing and practice management software, you’ll be able to bill for claims prior to October 1 properly, as well as bill for new claims requiring the new codes without costly billing mistakes that will delay your payment and client reimbursement.

Mind the Service Dates

Insurance companies expect claims with service dates prior to October 1 to be submitted using ICD-9 codes. In addition to the ICD-10 transition, mental health practice management professionals also need to manage the switch from DSM-IV to DSM-5. Make sure your mental health billing software can provide appropriate ICD-10 codes for both DSM-IV and DSM-5 to ease this transition.

Your current notes with diagnosis in the DSM-IV format will not need to be changed for clients. Having to make such changes will be a major undertaking for most practices, especially if you’re a large practice seeing lots of clients. EHR systems like TheraNest will automatically track the cut off date for you by submitting for services prior to the cut off date in the ICD-9 format and services from October 1 will be in the ICD-10 format.

The Center for Medicare and Medicaid Services (see CMS resource guide) recommends preparing for the transition by identifying the ICD-9 codes you use most often in your practice, then familiarize your staff with the ICD-10 codes that will replace them.

We recommend you use your practice management software to generate test claims and identify changes that need to occur in your practice by identifying coding errors generated by the test claims. Track any rejections so that your practice management software provider can help you troubleshoot problems with your reimbursement claims.

Use tools to help ease transition.

TheraNest has created a valuable tool to help you quickly look up and cross reference ICD and DSM associated codes. Try using our DSM-IV and DSM 5 to ICD-10 Codes Converter to help your private practice transition as smoothly as possible. Did you know that TheraNest automatically translates discontinued DSM-IV/ICD-9 codes into acceptable DSM 5/ICD-10 ready notes and claims? Compliance with the updated codes is essential for a successful private practice and a great practice management software like TheraNest can make a huge difference during this transition. If you need help or have further questions during the process, do not hesitate to reach out to us at TheraNest.