Payers seem to adapt well to ICD-10 launch

Earlier this month, healthcare providers across the United States updated their systems to accommodate the new ICD-10 coding set. While some insurers anticipated early billing problems because of the switch to the new coding system, the transition appears to have been relatively smooth.

Aetna, Humana, Anthem and Cigna told Healthcare Finance that they were following federal guidelines and are not denying Medicare Part B physician fee schedule claims that lack specificity, as long as they contain an ICD-10 code from the right family of codes. UnitedHealth Group, Kaiser Permanente and Harvard Pilgrim Health Care all declined to share their policies, according to the article.

Payers seemed generally prepared for the Oct. 1 launch. Seven out of 8 payers indicated in a Workgroup for Electronic Data Interchange survey released July 30 that their ICD-10-related internal business process design and development was "complete or nearly complete," Jessica Edmiston, senior vice president for performance review for National Medical Billing Services, wrote in a piece for Becker's ASC Review. 

These results, however, probably are skewed by larger payers with budgets that enable them to absorb better preparation efforts, she noted, adding that it may be months before definitive trend lines emerge that highlight how well payers were prepared. .

On the provider side, hospitals consider the ICD-10 launch a general success so far, with most reporting few hiccups, FierceHealthIT has reported.

To learn more:
- read the Becker's ASC Review article
- here's the Healthcare Finance article

Suggested Articles

Physician groups slammed a court ruling that overturns CMS' site-neutral payments rule for clinic visits.

Sixteen medical professionals, including six doctors and seven pharmacists, were among those charged in a Texas healthcare fraud and opioid takedown.

Blue Shield of California is piloting transportation benefits with some of its members in Sacramento.