This Bulletin and information should be shared with billing, business office, clinical and other staff who post diagnosis codes to MEDIK, or users generating HCFA-1500, UB-04 or electronic 837 claims.

Logik Solutions has been actively engaged in development related to the ICD-10 implementation that will take place on October 1, 2014 for some time now.

Since our last Bulletin on November 6th, 2014, we have received additional inquiries about the ICD-10 roll out addressed below.

We successfully submitted the electronic 837 claims file, using ICD-10 diagnoses, passing all edits for the structure, formatting and content of that file at the EDI level. This is a terrific start, but we need to know if you have any payers in your payer community that will participate in testing payer level edits before October 1. We also need to know if you have payers who might receive a waiver, allowing them to postpone acceptance of ICD-10 codes.

We are developing and deploying the programs needed to enter ICD-10 diagnosis and procedure codes in a coherent series of steps as follows.

February 1, 2014: An important aspect of overall readiness for the ICD-10 is the HCFA-1500
Version_0212_CMS_1500 which will be deployed to your MEDIK database on or about February 1, 2014. You may continue to print either the old or new version of the HCFA until April 1. After April 1 only the new HCFA will print from MEDIK.

Call Logik Solutions’ support staff when you are ready to commence generating the new HCFA.

April, 2014: Deployment of the ICD-10 diagnosis and procedure tables to your MEDIK Database
April, 2014: Deployment of an ICD-10 table lookup on the MEDIK diagnosis posting tab. This will permit the user to navigate the ICD-10 table, search ICD-10 diagnoses and look-ups in a fashion similar to the existing ICD-9 posting.. However, it will not permit the posting of an ICD-10 code before October 1, 2014. After October 1, 2014, only the ICD-10 codes will post to patients’ claims.

July, 2014: Logik Solutions provides a schedule of remote seminars/trainings to utilize the new ICD-10 diagnoses and procedure user interfaces throughout July and August. This will include a feature to down-code ICD-10 codes to ICD-9 codes for payers who are not ready to accept the ICD-10.

October 1, 2014: We will deploy and ‘turn on’ the ICD-10 diagnosis entry user interface on October 1.

Until October 1, claims for professional services and patients discharged from inpatient facilities will bear ICD-9 diagnoses.

On October 1, all professional services and inpatient discharges will bear an ICD-10 diagnosis.

If you encounter exceptional payers that are not ready to accept ICD-10 diagnoses on October 1, we will provide an ICD-10 to ICD-9 crosswalk for those payers. Claims destined for these exceptional payers will present the user with a payer specific crosswalk to complete. All subsequent claims for that payer will use the ICD-9 you have chosen until that payer is ready to accept ICD-10. Training for this cross-walk feature will take place in July.

Please let us know if any of your payers will require ICD-10 diagnoses before October 1, 2014. Also, please let us know if the down coding from ICD-10 to ICD-9 for payers who will not be ready is not viable for your facility.

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Bizarre ICD-10 Codes

With the medical coding system moving from a mere 18,000 codes (ICD-9) to one that encompasses 155,000 codes (ICD-10) in October 2013, there is a prodigious amount of detail added to what physicians and hospitals may bill. Coders are relieving their stress by poking fun at the coding system, and some of the new codes are seriously funny! As your abstracting your next chart these comorbidities might lend weight to your payment.

  • W22.02XA, “walked into lamppost, initial encounter
  • W22.02XD, “walked into lamppost, subsequent encounter”
  • R46.0 is “very low level of personal hygiene”
  • V91.07XA, “burn due to water-skis on fire”
  • R46.1 is “bizarre personal appearance”

… and a few that are made-up.
C193.44. “Yelled fire when he fell into the chocolate.”
R97.01 “Delusional, Severe. Thinks insurance company will cover her procedure.”