EyeNet Magazine

Savvy Coder: Coding & Reimbursement
Countdown to ICD-10-CM Implementation, Part 1
By Sue Vicchrilli, COT, OCS, Academy Coding Executive
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(PDF 70 KB)

On Sept. 30, 2014, at 4:30 p.m. Eastern Daylight Time, ICD-9 will become a thing of the past and ICD-10 will be implemented. How can your practice ensure a smooth transition? This month, EyeNet provides a checklist of all that needs to be done before Oct. 1. Upcoming articles will provide all ophthalmic subspecialties with the information they need to tackle this new coding system.

To Be Done Before Oct. 1

Identify your practice’s  ICD-10 coordinator(s).

◻ Estimate a budget inclusive of software and education.

◻ Have the entire staff participate in formal ICD-10 training. The Academy and AAOE provide the following courses and books:

  • CODEquest: Conquering ICD-10-CM four-hour course. (Visit www.aao.org/codequest to see when this course is scheduled near you—this month, it takes place seven times: on March 1, in Pontiac, Mich., and Salt Lake City; on March 7, in Freeport, Maine; on March 8, in Dallas; on March 15, in Houston; on March 22, in Portland, Ore; and on March 29, in San Marcos, Texas.)
  • 90 Minutes to Conquering ICD-10-CM for Ophthalmology online course (product # 0120355V; purchase it at www.aao.org/store).
  • 2014 ICD-10-CM for Ophthalmology book (#0120343; www.aao.org/store).
  • Conquering ICD-10-CM: Your “How-To” Guide for Ophthalmology book (#0120345; www.aao.org/store).

◻ Use quick references from www.aao.org/icd10.

◻ Communicate with your practice management system vendor and upgrade to the version that supports ICD-10.

◻ Confirm that system vendors, clearinghouses, and/or billing services will support changes to ICD-10.

◻ Have your practice management system vendor upload ICD-10 codes.

◻ Participate in ICD-10 test week, March 3-7.

◻ Query your most frequent commercial insurance payers regarding their timing of testing.

◻ Order new CMS 1500 forms (mandated implementation date is April 1, 2014).

◻ Upgrade your practice management system to support the new CMS 1500 form and Electronic Data Interchange (EDI) format.

◻ Identify opportunities for improved documentation in chart templates and electronic health records (EHRs) to support ICD-10.

◻ Run a diagnosis productivity report for each physician.

◻ Convert most frequently reported codes to ICD-10.

◻ Request and review insurance policies and prior authorization requirements with new ICD-10 codes.

Strikethrough or delete from your system unspecified codes that are not payable.

◻ Create electronic libraries of diagnosis code options.

◻ Develop superbills or charge sheets.

◻ At least 30 days prior to implementation, start identifying the appropriate ICD-10 code, but still submit the ICD-9 code for payment.

◻ Discuss any issues during staff meetings.

◻ Review the “Questions and Answers” page of www.aao.org/icd10.


To Be Done on Oct. 1

Begin reporting ICD-10 codes.


NEXT MONTH: A quick guide to the new terminology in ICD-10.


ICD-10 Champions

The Academy and AAOE would like to thank the eight ophthalmic coding experts who have been helping to prepare its ICD-10 resources:

Jennifer Arbuckle, CPC, OCS
Elizabeth Cottle, CPC, OCS
David B. Glasser, MD
Gordon E. Johns, MD
Rajiv R. Rathod, MD, MBA
Michael X. Repka, MD, MBA
Sue Vicchrilli, COT, OCS
E. Joy Woodke, COE, OCS


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