Please see the message from Bob Schultz (Director of Billing):
Good afternoon Alignmed billing partners and distributors,
As many of you are aware the implementation of the mandatory new ICD-10 program which replaces ICD-9 takes effect in 30 days. This means all orders with a date of service (DOS) on or after 10/1/15 will need these new codes listed on the LMN/RX or in the body of the face sheet or notes in order to be accepted or more importantly billable and payable. ICD-10 codes are composed of 3,4,5,6 or 7 characters and can be subdivided to provide greater specificity.
This is not a procedure implemented by Alignmed but a mandatory requirement enforced by CMS or Centers for Medicare and Medicaid Services which all commercial insurances will follow. All of your clinicians as well as all of your offices will be familiar with this new program as it has been talked about for years and should be getting weekly updates, if not daily countdowns.
I have cut a pasted a response from one of our billing partners as most billing partners, or if you do your billing in house will also have the same response. I highly encourage you to visit the website and familiarize yourself with this as I know it can be nauseating reading and confusing if you have not been doing DME for an extended period of time. We here at Alignmed will do our best to support you but are in the same boat as you, we are also learning and don't have all the answers.
Hopefully the dog days of a slow summer (and the heat) are behind us and prepared to jump sales as we move into the fourth quarter.
Have a great day and good selling,
Bob Schultz | Director of Medical Billing & Operations
2909 Tech Center Drive, Santa Ana, CA 92705
P 866-987-5433 ex 222 C 714-624-0752
F 888-822-2313
From: Trish Terena [mailto:trish@medequiportho.com]
Sent: Friday, August 21, 2015 4:31 PM
To: Bob Schultz <bobschultz@alignmed.com>
Cc: Soren Lind <soren@medequiportho.com>; Kasey Bancroft <kasey@medequiportho.com>
Subject: RE: ICD10
Sent: Friday, August 21, 2015 4:31 PM
To: Bob Schultz <bobschultz@alignmed.com>
Cc: Soren Lind <soren@medequiportho.com>; Kasey Bancroft <kasey@medequiportho.com>
Subject: RE: ICD10
Hi Bob,
Yes, we do need the ICD-10 codes listed on the RX or in the medical notes.
It should not be difficult for the physician's staff to list the ICD-10 on the RX or in the notes because they have been preparing for the conversion for several years therefore they are ready for the change. October 1, 2015 is a nation-wide start date that affects all medical professionals.
There are so many new codes with ICD-10 that we really can't correctly convert an ICD-9 code to the correct ICD-10 in our office. The new codes will be very specific to a diagnosis, for example, instead of OA of knee, the new ICD-10 will list OA in the right knee, medial compartment.
Here is a link I found on the CMS website for orthopedic ICD-10 codes for your review.
Let me know if I can assist further.
Trish Terena
Director of Sales
Confidentiality Notice:
The information and/or any attachments to this e-mail contain confidential information that is legally privileged. This information is intended only for the use of the individual or entity named in the e-mail. The above authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of these documents is strictly prohibited. If you have received this information in error, please notify the sender immediately and arrange for the return or destruction of these documents.
From: Bob Schultz [mailto:bobschultz@alignmed.com]
Sent: Friday, August 21, 2015 4:21 PM
To: Trish Terena
Cc: Soren Lind; Kasey Bancroft
Subject: FW: ICD10
Importance: High
Sent: Friday, August 21, 2015 4:21 PM
To: Trish Terena
Cc: Soren Lind; Kasey Bancroft
Subject: FW: ICD10
Importance: High
Hello Trish,
Does this mean that all orders we send you there going to have the ICD10 codes listed on the LMN/RX or somewhere on the order? I assumed that you all have coders on staff that can take a procedure/DX and code it?
Please let us know and have a great weekend,
Bob Schultz | Director of Medical Billing & Operations
From: Shauna Goodey [mailto:shauna@medequiportho.com]
Sent: Friday, August 21, 2015 10:48 AM
To: Bob Schultz <bobschultz@alignmed.com>; Kim Abellaneda <kabellaneda@alignmed.com>; Monica Magallon <mmagallon@alignmed.com>; Kristen Dagampat <kdagampat@alignmed.com>
Subject: ICD10
Importance: High
Sent: Friday, August 21, 2015 10:48 AM
To: Bob Schultz <bobschultz@alignmed.com>; Kim Abellaneda <kabellaneda@alignmed.com>; Monica Magallon <mmagallon@alignmed.com>; Kristen Dagampat <kdagampat@alignmed.com>
Subject: ICD10
Importance: High
As of October 1 all claims have to be submitted with the new ICD10 codes.
Claims cannot be submitted with the existing ICD9 codes. That means all original claims, resubmits, appeals, reconsiderations etc..
Since there can be a couple of weeks between item being dispensed and the claim leaving here we need to have ICD10 codes on paperwork starting Sept 10.
Please talk to your referral sources and make sure they will provide you with ICD10 codes
Thank you,
Shauna Goodey
Senior Account Manager/EDI Claim Specialist
Confidentiality Notice:
The information and/or any attachments to this e-mail contain confidential information that is legally privileged. This information is intended only for the use of the individual or entity named in the e-mail. The above authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulation and is required to destroy the information after its stated need has been fulfilled. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of these documents is strictly prohibited. If you have received this information in error, please notify the sender immediately and arrange for the return or destruction of these documents.
