The transition to the new ICD-10 coding system took effect on Oct. 1, 2015. Do you need some guidance? TMA has you covered with a variety of tools and resources to get you up to speed.
Remember: ICD-10 is service-date driven, so if you file a claim on or after Oct. 1 for services you provided Sept. 30 or earlier, you must file the claim using ICD-9 codes. If you run into problems submitting claims, send a report to TMA's Hassle Factor Log or email PaymentAdvocacy@texmed.org. TMA staff will be monitoring the reports and contacting health plans, Medicare, or Medicaid as necessary.
Payers expect they'll receive late filings and adjustments of pre-Oct. 1 claims and will continue to accept ICD-9 codes for those claims. Submit adjusted claims using the code set with which you originally filed the claim. Never combine ICD-9 and ICD-10 codes on one claim.
Read more about ways TMA can help.
If you think a Novitas local coverage determination (LCD) policy is missing an appropriate ICD-10 code, there is a fast and easy way to submit that information to Novitas. You can request an LCD reconsideration, using one of two ways:
The Novitas policy team will expedite ICD-10 requests for review. (Note: This is only for ICD-10 coding modifications. If you want to request a modification of a LCD policy to expand coverage of a service, you will need to submit clinical evidence.) Please send TMA a copy of the information you submit to Novitas at email@example.com or via fax at (512) 370-1632.
New Member Benefit Offers Help With ICD-10 Migration
To help with the transition to ICD-10 on Oct. 1, TMA is offering TMA members free access to a powerful new tool offered by e-MDs.
The e-MDs ICD-10 Code Search Tool offers TMA member physicians and their staff the ability to apply the right ICD-10 coding at the point of patient contact, improving the rate of accepted claims and reducing frustration. Using a combination of keyword filters, anatomical locations, gender, and age, the tool offers a highly intuitive way to build a narrow list of billable ICD-10 codes based on user preferences.
Free access to this new resource is just one benefit of being a TMA physician member. Practices with less than 100-percent membership can still use the tool, but at a fee of $1,250 per nonmember. If your practice would like to take advantage of this perk, but you are not a TMA member, join TMA now or call the TMA Knowledge Center at (800) 880-7955 for assistance. TMA members can get started immediately at no cost by logging into your TMA account for more information.
*This tool is a resource to assist in ICD-10 code selection. It does not guarantee the codes selected and reported by the user are supported by documentation or ensure claim acceptance and correct payer reimbursement.
If you have difficulties submitting ICD-10 claims due to being unable to complete the necessary systems changes or having issues with your billing software, vendor, or clearinghouse, the following claims submission alternatives are available:• Free billing software;• Provider internet portals;• Direct Data Entry (DDE); and• Paper claims.These options may work for some physicians, but it is necessary to read and understand ALL the requirements that must be met.
Get the details about each claims submission alternative in the CMS document.
Now available! Three-hour online courses. Choose from 21 medical specialties to learn physician documentation tailored to your practice type. Each physician-developed course shows you critical documentation elements you'll need to maintain payment under ICD-10. In addition, these courses look at the top clinical conditions for each specialty with emphasis on their associated documentation and coding requirements. Complete this online documentation training now! Use coupon code 10DOCTMA and save $100 on the registration.
On Demand Webinars
Did you miss a previous seminar, or are you just getting started in preparing for ICD-10? Register for on demand recording of ICD-10 planning and implementation courses. View on demand webinar list.
Essentials in ICD-10 Coding Receive detailed answers to your ICD-10 questions and gain confidence in working with these codes.
ICD-10 Starts With Physicians
Practices should use this extra time to plan for the transition to a new code set. If your practice hasn't developed an implementation plan, the time to start is now.
ICD-10 Now! How and Why On Demand Webinar
Once you learn the pitfalls, you can begin to prevent problems. This webinar will teach you everything you need to know about starting your ICD-10 transition.
Achieving ICD-10 Implementation Success
The ICD-10 implementation challenge can seem overwhelming given all its moving parts. This workshop will get your practice fully engaged in the transition.
ICD-10 Documentation and Auditing: Success Is in the DetailsWith the conversion to ICD-10-CM set to take effect Oct. 1, 2015, the time to educate physicians and staff is now. A good understanding of the new coding and documentation conventions is essential to mastering ICD-10 and avoiding claim denials. Have your ICD-10-CM code book ready and register now to get a hands-on look at coding in ICD-10.
TMA Education Center
Start now and gain the knowledge needed for a seamless transition. View all of the courses available on the TMA Education Center.
ICD-10 Transition Basics - CMSConsult these CMS fact sheets to understand the basics of ICD-10, and what you’ll need to get started on your transition.
ICD-10 Quick Start Guide and Implementation Infographic - CMSThese resources outline the 5 steps health care professionals should take to prepare for ICD-10 by the October 1, 2015, compliance date.
Centers for Medicare & Medicaid Services (CMS) Road to 10 programDeveloped in collaboration with physicians from a variety of specialties, Road to 10 provides free and actionable ICD-10 resources, including an action plan, specialty-specific tools, webcasts, and more.
ICD-10 Facts and Myths - CMSThis fact sheet from CMS provides responses to myths about ICD-10 and resources.
Texas Medicaid ICD-10 Benefit Changes
Updated Texas Medicaid medical policies, which include proposed ICD-10-CM diagnosis codes that will be effective for dates of service on or after October 1, 2015.
ICD-10 Special Bulletin
This publication contains all of the Texas Medicaid and CSHCN Services Program benefit changes as a result of the transition from ICD-9-CM to ICD-10-CM.
ICD-10 Readiness Questionnaire for EHR Vendors by AHIMA - American Health Information Management Association (AHIMA)
Practice ConsultingCustom transition solutions and professional coding help for your practice.
Need ICD-10 Help? TMA Has Tools to Help You Make the Switch (Action, Oct. 1, 2015)
Will You Be Ready for ICD-10? (Action, Sept. 15, 2015)
ICD-10: All Systems Ready? (E-Tips, Sept. 9, 2015)
TMA Survey Says Texas Doctors Concerned About ICD-10 Rollout (Action, Sept. 1, 2015)
TMA Tips on Move to ICD-10 (Action, Sept. 1, 2015)
New Member Benefit Helps With ICD-10 Migration (Action, Aug. 17, 2015)
The ICD-10 Grace Period: What It Is and Is Not (Action, Aug. 17, 2015)
Feds Answer Questions on ICD-10 Flexibilities (Action, Aug. 3, 2015)
The Move to ICD-10: Dates of Service (E-Tips, July 28, 2015)
Pay Attention to ICD-10’s Seventh Character (E-Tips, June 23, 2015)
Set Your Post-ICD-10 Implementation Goals (E-Tips, Mar.12, 2014)
Transition to ICD-10: Role of Clearinghouses (E-Tips, June 11, 2013)
Fiery Water Skis? There's an ICD-10 Code for That! (Action, May 1, 2013)