Delta Connect Blog

The National Association for Home Care & Hospice (NAHC) has recently learned that the organizations responsible for the official ICD-10 coding guidance has issued clarification that would require home health agencies to indicate an “A” (initial encounter) in the 7th character for some ICD-10 codes. An “A” in the 7^th character should be used for any encounter where the patient is still receiving active treatment for the clinical condition, including home health.

Experts have understood that an "A" would never be appropriate as the 7th character for a home health diagnosis. The reason being is the patient would have been seen initially in another setting. But, the initial encounter definition in the ICD-10 coding guidelines is broader than experts realized.

With ICD-10 codes being required beginning October 1, 2015, home health and hospice providers need to prepare for dual coding prior to the October deadline.  With 60-day episodes for home health and 90-day episodes for hospice, agencies could find themselves in a situation where ICD-9 codes must be used for the start of care OASIS and ICD-10 codes must be used for final claim submissions. 

ICD-10 is coming. Despite smaller organizations and physician's practices wanting a delay, CMS is sticking with the October 1, 2015 compliance date.   

Is your home health organization taking the steps needed to be ICD-10 compliant?  By this time, your organization should have a strategy in place to comply with the new diagnosis coding. You should have your ICD-10 compatible software installed and be testing with your applicable vendors and payers. Staff should have already started or will soon be starting to receive training on ICD-10.  

Organizations shouldn't be hoping for another delay. Home health providers should be actively reviewing their project plan on a regular basis and crossing tasks off the list. 

The infographic below provides a high-level outline of what you need to be doing to be ready for ICD-10 on October 1, 2015.   

Visit the CMS ICD-10 website for the latest news and resources to help you prepare for the October 1, 2015, deadline.

CMS is requesting approval by the Office of Management and Budget (OMB) for the OASIS data set to accommodate ICD-10. This new version of the OASIS is referred to as the OASIS/ICD-10 data item set.