Practice Economics

ICD-10: Dual coding is only for testing, claims backlog


 

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There’s plenty to be confused about when it comes to the transition to the new ICD-10 coding system in October 2015. But the government has issued some clarification about at least one issue: when to use dual coding.

Dual coding, also called dual processing, generally means using both ICD-9 and ICD-10 at the same time when submitting claims.

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Dual coding generally means using both ICD-9 and ICD-10 at the same time when submitting claims.

In an e-mail July 10, officials at the Centers for Medicare & Medicaid Services (CMS) said physicians and coders may engage in dual coding as a way to test their ICD-10 readiness before the compliance date. They may also code in both systems after the compliance date, if they have a backlog of claims.

Here’s how it works: Before ICD-10 goes into effect on Oct. 1, 2015, physicians and coders can practice by coding current claims in both systems to see if they have the right level of documentation for the new system. ICD-10 codes can also be used to test whether payers and clearinghouses are ready to receive and process the new codes. However, only the ICD-9 code can be sent to payers as part of a "live" transaction before the compliance date.

Physicians may also find that they will use both coding sets for a short period of time after the compliance date, if they need to submit claims with a date of service that occurred before Oct. 1, 2015.

But the physicians and coders don’t get to choose which system to code in. The date of service determines whether ICD-9 or ICD-10 is used, according to CMS, with services performed before Oct. 1 getting an ICD-9 code and services on and after Oct. 1 receiving an ICD-10 code.

CMS is expected to release a regulation soon with more details on the rollout of ICD-10.

mschneider@frontlinemedcom.com

On Twitter @maryellenny

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