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ICD-10 Implementation Guidelines

ICD-10 Implementation

October 1, 2013, marks a very important date for physicians and other health care providers—the beginning of ICD-10 Implementation. The Medical Society of Delaware (MSD) has participated in several conference calls addressing information ranging from the basics of ICD-10 through its actual implementation.

The Centers for Medicare and Medicaid Services (CMS) has developed educational materials on the Medicare-Fee-for-Service 5010 program to provide technical assistance and direction.  Resources include: 

·    Central Version 5010 and D.O Webpage on the CMS website http://www.cms.gov/Versions5010andDO/

·    Educational Resources (MLN articles, fact sheets, readiness checklists, brochures, quick reference charts and guides, FAQ’s, and transcripts from previous national provider calls)

http://www,cms.gov/Versions5101andDO/40 

Action Steps You Can Take Now for Medicare FFS Changes:

·    Contact your medical billing system vendor and ask:  Does your license include regulation updates?  Will the upgrade include acknowledgement transactions 277CA & 999?  Will the upgrade include a “readable” error report produced from these 277CA and 999 transactions?

 

·    Inquire as to when your vendor is planning to upgrade your system to be sure your vendor can assure your transition well before the cut-off date of January 1, 2012. 

 

·    Evaluate the impact to your routine and begin planning for training and transition.

MSD continues to monitor CMS activity as it pertains to the ICD-10 Implementation for the purpose of communicating out to our members the latest in ICD-10 information and resources.  Visit the CMS ICD-10 website at http://www.cms.gov/icd10/ for the latest information and links to resources for to prepare for ICD-10 implementation in a 5010 environment.

New Medical Records Copying Rules Effective November 11, 2009

Fees for Copying Medical Records

 

Step 1:  Is the request for copies related to a Workers’ Compensation claim?  If yes, then use the following guidelines.  If no, then proceed to Step 2.

TITLE 19 LABOR
DELAWARE ADMINISTRATIVE CODE
1000 DEPARTMENT OF LABOR
1300 Division of Industrial Affairs
1340 The Office of Workers’ Compensation
1341 Workers’ Compensation Regulations

 4.19 Fees for Non-Clinical Services

        4.19.1    Pursuant to 19 Del.C. §2322B(m), fees for certain non-clinical services are set as follows, and will be periodically revised upon recommendation of the Health Care Advisory Panel to reflect changes in the cost of providing such services:

             4.19.1.1   Retrieving, copying and transmitting existing medical reports and records, to include copying of medical notes and/or records supporting a bill or invoice for charges for treatment or services:

  • $25.00 for search and retrieval
  • $1.25 per page for first 20 pages
  • $.90 per page for pages 21 through 60
  • $.30 per page for pages 61 and thereafter

 

Step 2:  Is the request for copies from the patient or the patient’s personal representative (e.g. patient’s guardian or Power-of-Attorney)?  If yes, then use the following guidelines.  If no, then proceed to Step 3.

 

Title 24 Regulated Professions and Occupations

DELAWARE ADMINISTRATIVE CODE
DEPARTMENT OF STATE

Division of Professional Regulation

1700 Board of Medical Practice

30.0 Patient Records; Fee Schedule for Copies

30.1 A patient requesting of a copy of his or her own medical records to be transferred to another physician or to be obtained on their own behalf may be charged a reasonable fee not to exceed the fees set forth in the schedule below, excluding the actual cost of postage or shipping if the records are mailed:

·         $2.00 per page for pages 1-10

·         $1.00 per page for pages 11-20

·         $0.90 per page for pages 21-60

·         $0.50 per page for pages 61 and above

30.2 The fees set forth in section 30.1 above shall apply whether the records are produced in paper or electronic format.

30.3 The full cost of reproduction may be charged for copies of records not susceptible to photostatic reproduction, such as radiology films, models, photographs or fetal monitoring strips.

30.4 Payment of all costs may be required in advance of release of the records except for records requested to make or complete an application for a disability benefits program.

Also important to note:

·        To be clear, the cost of postage and shipping may be charged in addition to the fees set forth above.

·         Under HIPAA, a retrieval fee is not considered a part of the reasonable cost of copying records, so a retrieval fee may not be charged to a patient.

·         The Board of Medical Practice in its final order dated November 1, 2009, affirmed that the fee guidelines above apply to patient requests only, and NOT to requests by third parties, such as attorneys or employers.

·         Under Title 24 § 1761(l) of the Delaware Code, a physician shall have 45 days from the closure of the record or the assembly of a complete record to fulfill a request for medical records unless a faster response is medically necessary.

·         A physician still has the option to provide a summary of the record to another physician at no charge to the patient, in lieu of transferring the entire record, if agreed to by the patient and the receiving physician.

 

 

Step 3:  Requests from third parties such as payers, plaintiffs’ attorneys, or employers are not regulated, unless related to a workers’ compensation claim.  So if a third party demands that you adhere to the guidelines above for a non-workers’ comp claim, tell them they are wrong and present this document as support.

 

PRACTICE RESOURCES
  • Discounted Mailing Labels:  Moving, retiring, or announcing a new partner in your practice?  MSD members may purchase mailing labels at a greatly reduced cost. You can purchase the entire membership, by county or by specialty.

  • Leadership: MSD provides its members participation and leadership opportunities for an active role in the Delaware medical community.
  • Representation: MSD represents physicians of all specialties throughout the state in shaping the future of medical care in Delaware and across the nation.
  • Networking: Delaware physicians have the opportunity to meet and share ideas with colleagues outside their practice and specialty.
  • Health Care Reform: As health care reform moves forward, MSD stays at the forefront of policy-making locally and nationally.
  • Advocacy: MSD is the voice of the medical profession in our state legislature and is actively engaged in promoting laws that preserve quality patient care. 
FYI
Red Flags Rule UPDATE

AMA-led lawsuit seeks relief from unlawful enforcement of misguided federal regulation

The AMA, American Osteopathic Association (AOA) and the Medical Society of the District of Columbia (MSDC) filed a suit in federal court on May 21, 2010 seeking to prevent the Federal Trade Commission (FTC) from extending identity theft regulations to physicians.

The complaint, prepared by the Litigation Center of the AMA and State Medical Societies, targets the contentious “red flags rule,” which requires creditors to implement safeguards against identity theft. The medical societies charge that the FTC’s rule exceeds the powers delegated to it by Congress and that its application to physicians is “arbitrary, capricious and contrary to the law.”

HIPAA
New Online Certificate Program for Technicians

The American Association of Diabetes Educators (AADE) launches new online certificate program for healthcare technicians; Fundamentals of Diabetes Care: A Certificate Program for Healthcare Technicians, a six-module, self-paced online certificate program designed for medical assistants, licensed practical nurses and other healthcare technicians. Click Here for more details.

Pro Assurance Risk Mgmt Seminars
Help For Elderly Delawareans

Do You Serve Elderly Delawareans In Your Office? Have you encountered a patient in need of assistance with an outstanding medical bill? ElderInfo is a valuable resource for patients and staff alike.Click here for main Elderinfo brochure. Click here for the financial brochure.

Notice to all users

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FYI-Committee Meetings are open to committee members only. Please contact the Society office if you want to register in advance as a guest attendee.
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