SOURCE: LogixHealth

LogixHealth

March 02, 2016 11:30 ET

LogixHealth Analyzes Medicare's Dashboard Publication of Initial ICD-10 Claims Processing Results

BEDFORD, MA--(Marketwired - Mar 2, 2016) - LogixHealth, a leading provider of internet and software enabled coding, billing, analytics and management services for hospital and physician practices nationwide, provides services for millions of Emergency Department (ED) visits across 35 states, and has analyzed the Final 2015 ICD-10 Claims Dashboard Medicare Fee-for-Service Metrics.

On October 1, 2015, the U.S. health care system changed the way health care services are coded and transitioned from ICD-9 diagnosis coding to ICD-10. The more detailed ICD-10 coding system provides more granularity regarding illness and severity, and enables the tracking of newer and novel diseases. Whereas media reports often joke about obscure codes, such as being struck by an Orca, healthcare providers had a more serious concern of whether the nation's largest payer, Medicare, would be ready to process claims. On February 24th CMS acting Administrator Andy Slavitt highlighted the success that CMS has had in processing ICD-10 claims, including some specific data.

Metrics Historical Baseline
(ICD-9)
Q4 CY 2015
(ICD-10)
Claims Submitted 4.6 Million/day 4.6 Million per day
Claims Rejected 2% 1.9%
Claims Rejected 0.17% 0.07%
Claims Rejected 0.17% 0.07%
Claims Denied 10% 9.9%

"Our experience is consistent with the released CMS data and claims processing is going smoothly", states Elijah Berg, MD, FACEP CEO of LogixHealth.

Importantly, CMS created a 12-month grace period during which it will not reject any claims based on diagnosis coding as long as the ICD-10 diagnosis family is correct.

CMS has published the below FAQ:
Question: What happens if I use the wrong ICD-10 code, will my claim be denied?
Answer: While diagnosis coding to the correct level of specificity is the goal for all claims, for 12 months after ICD-10 implementation, Medicare review contractors will not deny physician or other practitioner claims billed under the Part B physician fee schedule through either automated medical review or complex medical record review based solely on the specificity of the ICD-10 diagnosis code as long as the physician/practitioner used a valid code from the right family. ..."

About LogixHealth:
LogixHealth, a leading provider of internet and software enabled coding, billing, analytics and management services for hospital and physician practices nationwide, provides services for millions of Emergency Department (ED) visits across over 35 states. We provide tools and resources to optimize financial performance and improve the quality of care. For more information, visit www.logixhealth.com.

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