EDI ICD-10 Systems Set Up Notes And Guidelines
EDI ICD-10 systems set up is important as ICD-10 involves new coding rules, so many health care entities are reviewing payment and benefit policies. The transition from ICD-9 to ICD-10 will change how everyone in health care will do business. Trading partners are exchanging information about their readiness plans and timelines for product development, testing, availability, and training. In order to upgrade EDI ICD-10 systems successfully, it is important to coordinate with business trading partners and test processes and transactions that use ICD-10 codes from beginning to end. It also is important to review and evaluate trading partner agreements and contracts during EDI ICD-10 systems set up.
Providers should plan to test their EDI ICD-10 systems early to help ensure they will be ready by the compliance date. Plan to test claims, eligibility verification, quality reporting, and other transactions and processes that involve ICD-10 codes from beginning to end. It is important to test both within your organization and other business partners.
Beginning steps in the testing phase include:
- Working with practice management system and/or EHR vendors/IT staff and coders/billers to develop and test processes and systems using ICD-10 codes
- Determining when you will be ready to test, and working with providers and any clearinghouses or billing services that you use to schedule testing
- Developing a testing plan that outlines key dates and milestones for when tests should be completed
Steps you can take to ensure a smooth transition to ICD-10 include:
- Have a transition plan in place and make sure it documents the steps being followed and the dates that milestones will be achieved to comply with ICD-10 requirements
- Include vendor tasks in your plan and timeline, and make sure to communicate with your practice management system and/or EHR vendors regularly about ICD-10
- Establish an emergency fund to cover unexpected costs and possible reimbursement delays.