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WCH News

Unspecified ICD-10 Leads To Audit

Tuesday, November 10, 2015

Insurances Will Not Wait For You to Understand ICD-10

It has already been over a month since the implementation of ICD-10 has taken effect. The WCH Team wants you to know the risks of waiting until last minute to understand how to use ICD-10. The insurance companies are only giving a one year grace period for doctors to understand and implement the transition from ICD-9 to ICD-10 codes. If doctors wait until last minute to implement these codes, they risk facing an audit by the insurance company. If you over use unspecified diagnosis codes, you risk getting an audit as well. The implementation of ICD-10 now specifies some diagnoses where unspecified ones cannot be used. This means that if you keep relying on unspecified codes, you might write the wrong code and not receive payments. If you keep waiting to implement ICD-10 codes, you will have denials in your claims when the grace period is over for not being prepared. Please make sure that you are practicing how to implement ICD-10 codes to the best of your ability so that when the grace period ends, you will be prepared to transition fully from ICD-9 to ICD-10.

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