September 9, 2015
ATLANTA (September 9, 2015) – Clyde L Reese III, Esq., Commissioner of the Georgia Department of Community Health (DCH), various healthcare associations and Georgia Medicaid’s care management organizations are urging Georgia’s healthcare industry to make final preparations for the October 1, 2015 go-live of ICD-10.
“The Georgia Academy of Family Physicians, Georgia Association of American Pediatrics, Georgia Hospital Association, Georgia OBGYN Society, HomeTown Health, Medical Association of Georgia, Amerigroup Community Care, PeachState Health Plan and WellCare have been instrumental in raising awareness of the federal mandate and assisting stakeholders and providers in preparing for the (ICD-10) transition,” said Clyde L. Reese III, DCH Commissioner. “With less than 30 days to golive, it is of vital importance that providers are prepared to fully transition to ICD-10 in order to receive payment.”
The federally mandated transition from ICD-9 to ICD-10 pertains to all HIPAA-covered entities including providers, payers, vendors and their business associates. Claims submitted for services rendered on or after the compliance date that do not contain the ICD-10 coding will be pended, denied or rejected. Payments to providers cannot be made without the proper ICD-10 coding.
Vendors should monitor ICD-10 implementation and assist in troubleshooting and promptly resolving post-implementation issues following the transition. Providers should review processes to confirm effectiveness and sustainability regarding clinical documentation changes, coding practices and processes, revenue cycle processes and changes, and any other organizational changes made during the transition.
DCH has been conducting preparedness training for over a year. Stakeholders can access DCH’s ICD-10 materials and repository of recorded webinars by visiting dch.georgia.gov/icd-10. Stakeholders are also encouraged to view materials on the Center for Medicare and Medicaid Services (CMS) website (www.CMS.gov) and other online resources, such as www.aapc.com or www.ahima.com.
ICD-10 is a diagnostic coding system implemented by the World Health Organization (WHO) in 1993 to replace ICD-9. The system was developed by WHO in the 1970s and is now used in almost every country in the world. In the United States, ICD-10 usually refers to the U.S. clinical modification of ICD-10: ICD-10-CM. The new ICD-10 code set is scheduled to replace ICD-9, our current U.S. diagnostic code set on October 1, 2015. Another designation, ICD-10-PCS, which stands for procedural coding system, will also be adopted in the U.S. on October 1, 2015. ICD-10- PCS will replace Volume 3 of ICD-9-CM as the inpatient procedural coding system.
About the Georgia Department of Community Health
Through effective planning, purchasing and oversight, the Georgia Department of Community Health (DCH) provides access to affordable, quality health care to millions of Georgians, including some of the state’s uninsured and most vulnerable populations.
DCH is responsible for Medicaid and PeachCare for Kids®, the State Health Benefit Plan, Healthcare Facility Regulation and Health Information Technology in Georgia.
Clyde L. Reese III, Esq., serves as Commissioner for the Georgia Department of Community Health.
To learn more about DCH and its dedication to A Healthy Georgia, visit www.dch.georgia.gov.