July 1, 2013 Departments

News in Brief: July 2013

ASHA Helps Members Prepare for October 2014 ICD-10-CM Implementation

Implementation of ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) will take place in a little over a year. Will you be ready on Oct. 1, 2014?

New resources for audiologists and speech-language pathologists

ASHA has developed the following new resources to help audiologists and speech-language pathologists transition from ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) to ICD-10-CM.

  • ICD-9 to ICD-10 Mapping Tool: Enter an ICD-9 code and this Web-based tool provides a mapping to the appropriate ICD-10 code(s) [PDF].
  • ICD-9 to ICD-10 Mapping Spreadsheet: This no-frills reference is for those who want to view audiology- or speech-language-pathology–related mappings in one list.
  • ICD-10 Code Lists: Audiology- and speech-language-pathology–related disorders are culled from approximately 68,000 ICD-10 codes into manageable, discipline-specific lists.

All resources developed by ASHA are tailored to the needs of audiologists and SLPs and are based on extensive analysis by ASHA staff. Although several conversion tools and products are available, analysis by specialty organizations—such as ASHA—may be particularly useful. In a recent study published in the Journal of the American Medical Informatics Association, researchers found that only about 60 percent of ICD-9 codes translated to ICD-10 codes effectively.

However, 36 percent of ICD-9 codes were "convoluted" with entangled and non-reciprocal mappings, and 1 percent of ICD-9 codes had no corresponding code under ICD-10. For the study, the researchers from the University of Illinois-Chicago produced two mapping files based on Centers for Medicare and Medicaid Services data that were designed to translate between ICD-9 codes and ICD-10 codes.

Tips for a smooth transition

Prepare now to help avoid potential reimbursement issues. Use this checklist to ensure that you are taking the right steps to be ready for ICD-10 implementation:

  • Identify your current processes and systems that use ICD-9-CM codes. Wherever ICD-9-CM codes are now used, ICD-10 will take their place (for example, clinical documentation, superbills, billing software, electronic health record systems, quality reporting systems).
  • Contact clearinghouses, billing services, practice management system vendors and others with whom you conduct business. Ask them about their plans for ICD-10 updates, including when they expect to have them in place, and when you can begin testing the updated systems.
  • Discuss with your payers how the change may affect your contracts. Because ICD-10 codes are much more specific, payers may modify contracts or fee schedules. Consider using ASHA resources to inform payers about appropriate mappings for conditions that audiologists and SLPs treat.
  • Analyze the potential changes to your work flow and business processes.
  • Develop an implementation strategy. This should include a timeline and budget.
  • Consider staff training needs and identify educational resources. Engage clinicians and coders early so that they can begin to learn the new concepts and systems. However, start detailed training six to eight months prior to implementation, so the information is still fresh when the change takes place.
  • Test transactions using updated systems with your payers and others with whom you conduct business. Check to see when they will begin testing.
  • Be proactive and educate yourself!

ASHA will continue to post relevant information and resources. The Centers for Medicare and Medicaid Services have also developed useful ICD-10 implementation timelines and checklists that are customized for large practices, small and medium practices, small hospitals, and payers.

For help with specific questions regarding the ICD-10 transition, contact reimbursement@asha.org or 800-498-2071.

Janet McCarty, MEd, CCC-SLP, is ASHA private health plans advisor.

  • jmccarty@asha.org

Neela Swanson is ASHA associate director of health care economics and coding.

  • nswanson@asha.org

IES Invites Applications for FY2014 Grants

Sept. 4 is the deadline to submit applications to the U.S. Department of Education's Institute of Education Sciences for fiscal year 2014 grants to support education research and special education research. Applications became available June 6.

The Institute's National Center for Education Research will fund grants in five categories: education research, education research training, education research and development centers, statistical and research methodology in education, and partnerships and collaborations focused on problems of practice or policy. Each category contains several specific topics.
The Institute's National Center for Special Education Research will not accept grant applications in FY2014.

Grants are designed to provide national leadership in expanding fundamental knowledge and understanding of developmental and school readiness outcomes for infants and toddlers with or at risk for disability, and education outcomes for all. Applicants must be able to conduct scientifically valid research. Eligible applicants include public and private agencies and institutions—such as colleges and universities—and nonprofit and for-profit organizations.

Although Congress has yet to appropriate funds for FY2014, the Institute is inviting applications now so that applicants have time to prepare their proposals. The Institute may announce more topics later this year.

For more information, see the Federal Register notice [PDF].

The New DSM Is Out

In May, the American Psychiatric Association issued the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, which, notably for speech-language pathologists, includes changes to diagnostic criteria for autism spectrum disorder and communication disorders, including the new social (pragmatic) communication disorder.

This edition is the first since 1994 to revise the classifications and criteria of mental disorders. The changes were based on research and practice considerations.

DSM is the standard classification of mental disorders used in clinical and community settings in the United States and other countries. The new edition is available first in print, with an electronic version to be offered later this year. See more information on changes to DSM-5 at psychiatry.org.

For information about ASHA's role in the revision process, visit our DSM-5 page. Future articles in The ASHA Leader will provide more coverage and analysis of the changes.

Tubes and Adenoid Removal Help Patients with Otitis Media

A new federal research review [PDF] indicates that patients with otitis media with effusion benefit from placement of tympanostomy tubes and removal of the adenoids, either alone or in combination.

The systematic review, funded by the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, was conducted by the Research Triangle Institute-University of North Carolina at Chapel Hill Evidence-based Practice Center.

The treatment options for OME—a collection of fluid in the middle ear with no infection—decrease its duration by up to two years. However, results were mixed about any additional potential benefit of using both treatment options, and evidence of potential harms was associated with each: Drainage from the ear is common after placement of tympanostomy tubes and may persist; adenoidectomy may involve post-surgical hemorrhage, although rare. Consistent with current guidelines, newer evidence showed no benefit from nasal or oral steroids.

Additional research is needed to support treatment decisions in subpopulations, including adults, children with coexisting conditions such as craniofacial abnormalities or Down syndrome, and children who have received pneumococcal vaccination, which is associated with a reduced risk of acute otitis media.


  

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