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Press Start: Lead an Empowered Life as a Clinical Laboratorian

Are You Ready for ICD-10?

Published September 7, 2015 4:07 PM by Glen McDaniel

Come October 1st, 2015 Medicare will only accept claims (with a date of service on or after October 1, 2015) if they have a valid ICD-10 code. Is your lab ready to meet that directive?

 

Clinical laboratories are required to submit accurate and complete diagnosis codes in electronic and paper claims to third party payers. ICD-10 introduces more than 100, 000 new diagnostic and procedure codes that will impact diagnostic description and ultimately reimbursement. With ICD-10 comes greater specificity, including age and gender related codes. Claims with insufficient diagnosis coding can trigger denials, requiring both the lab and the provider to invest labor and time to resolve and, very often, creating inconvenience for the patient. It is imperative that the most specific ICD-10 code is provided to avoid these scenarios.

 

What has your lab done so far to prepare for ICD-10? Many organiazations have mounted massive education campaigns for staff using material developed inhouse, or by third parties including CMS itself (www.cms.gov/ICD10)

 

However, even labs that are very aggressive have to ensure that testing and care are nor delayed by assuming too aggressive a stance in terms of not performing testing until ICD-10 code has been attached to a test request. Some labs have developed a crosswalk to more easily “translate” an ICD-9 code into the most appropriate ICD-10 code as a last resort.  This is a strategy specifically recommended by American Clinical Laboratory Association (ACLA).

 

I  am interested in  hearing out your opinions of how laboratories will be affected by ICD-10, your readiness and strategies that your lab is using to meet this mandate. 

1 comments

We have done some education for staff. We still have problems now with doctors entering diagnosis and codes ICD-9!! Electronically I think we might be OK. But for some manually ordered tests like genetic tests and pathology specimens  sent to a reference lab we will be receiving specimens and paperwork with incomplete or incorrect codes. In the past we have had  our reference lab hold results until we get the proper codes. I think this will be a mess. As you said we cannot realistically refuse to test (or send out an unretrievable specimen) until we receive the right code. I think in many cases we (in the lab) are going to be the ones in the middle.

Miriam Talbot , MLS (ASCP) September 7, 2015 5:53 PM
Tacoma WA

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