Take this simple assessment to see how ready you are and get your ICD-10 success checklist.
ICD-10 Success Checklist
ICD-10 will affect your software, your superbills, your workflow, your documentation, and more. Use this checklist to help your practice ensure a successful transition.
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Kareo Product Readiness
View Kareo’s ICD-10 product features and learn more about our testing success.
Kareo ICD-10 Training
Learn more about ICD-10 by taking a live training with a Kareo ICD-10 Specialist or choose between 3 of our eLearning courses: Overview, ICD-10 Success Readiness Checklist & PM Features, and/or ICD-10 EHR Features.
Frequently Asked Questions
What is ICD-10?
ICD-10 is the 10th Edition of the International Classification of Diseases (ICD). ICD is the standard diagnostic tool for epidemiology, health management and clinical purposes. This includes the analysis of the general health situation of population groups. It is used to monitor the incidence and prevalence of diseases and other health problems.
Similar to the implementation of ICD-9 in the United States, ICD-10 will also have two parts:
- ICD-10-CM is used for coding diagnosis (CM stands for Clinical Modification)
- ICD-10-PCS is intended only for inpatient procedure coding (PCS stands for Procedure Coding System)
- ICD-10-CM is used in all healthcare settings, and ICD-10-PCS is only use in Inpatient Hospital settings.
- ICD-10-CM utilizes 3-7 digits compared to 3 to 5 digits with ICD-9-CM.
- ICD-9 had over 14,000 codes while ICD-10 has over 68,000 different codes. When is the ICD-10 compliance deadline?
The deadline is October 1, 2015. Any claims with dates of service on or after the deadline will require the use of ICD-10 codes.
What does compliance mean, and who is affected?
ICD-10 compliance means that everyone covered by the Health Insurance Portability and Accountability Act (HIPAA), and not just those who submit Medicare or Medicaid claims, must use ICD-10 codes for healthcare services provided on or after October 1, 2015.
This means that all software systems currently in use by practices that utilize ICD-9 will be required to update to support the use of ICD-10.
ICD-10 training will be required for all healthcare providers, clinical staff, coders, billing and administrators. They will also need to develop new practice policies and guidelines, and update paperwork and forms. Practices should also create cheat sheets that list their most frequently used ICD-9 codes and their ICD-10 equivalents.
What if I'm not ready by the compliance deadline?
The biggest impact to your practice will be cash flow since any ICD-9 codes used in transactions for services or discharges on or after the deadline will be rejected as non-compliant and the transactions will not be processed. Physicians are urged to plan for reimbursement delays and arrange for emergency funding to cover all practice expenses (overhead, staff salary, supplies, etc.) for a minimum of three months.
What will Kareo do about payers or other agencies that are not converting to ICD-10?
Kareo understands that there will be a general industry lag in the adoption of ICD-10-CM for some non-HIPAA entities and will continue to support the use of ICD-9-CM within the system during the transition.
Is Kareo ready to support practices as they transition to ICD-10?
Absolutely! Our teams continue the improvement of Kareo's products to provide our customers with all the tools they will need for the October 1, 2015 conversion date.
What specifically is Kareo doing in the product?
Kareo is actively working to support practices by providing critical preparation tools. The Most Commonly Used Diagnosis Report provides a list of a practice's most commonly used ICD-9 codes. The crosswalk can suggest potential corresponding ICD-10 codes based on this report. Our practices also have the ability to dual code, representing a diagnosis in both ICD-9 and ICD-10. And the ICD-10 Success Dashboard tracks a practice's progress toward the October 1, 2015 deadline.
What should practices be doing today and over the coming months to prepare?
If practices have not already done so, their primary focus should be three fold:
- Financial Impact - Does the practice have enough financial resources to cover day-to-day operations, if payments are delayed?
- Certified ICD-10 Coding - Billers and coders should attend a certified coding program to learn the nuances of this new code set.
- Clinical Documentation - The foundation of a good claim is the documentation upon which it is based; providers are encouraged to attend a seminar that addresses the new standards for documentation for ICD-10.
What if I'm not ready by the compliance deadline?
The biggest impact to your practice will be cash flow since any ICD-9 codes used in transactions for services or discharges on or after October 1, 2015 will be rejected as non-compliant and the transactions will not be processed. Physicians are urged to plan for reimbursement delays and arrange for emergency funding to cover all practice expenses (overhead, staff salary, supplies, etc.) for a minimum of three months.
Will your software have ICD-9 to ICD-10 crosswalk?
Yes, there is currently a crosswalk in Kareo Practice Management. You can find more information about it here http://helpresources.kareo.com/help/releasenotes/2014-0411-pm and here http://helpresources.kareo.com/help/practice-management/howto/icd10-diagnosis-crosswalk
Who is responsible for testing - Kareo or the practices?
The good thing for our customers is that we do the testing for them! Kareo will continue testing with our clearinghouses to make sure that everything is ready for October 1, 2015. Separately, our clearinghouses have participated in payer testing with a 95% and higher success rate.
Is Kareo ready to support practices as they transition to ICD-10?
Is Kareo’s software ICD-10 ready?
What should practices be doing to prepare?
Will your software have ICD-9 to ICD-10 crosswalk?
How is Kareo testing with their partner EHRs?
When will you update my current products and applications for ICD-10? Is there an added cost?
As a cloud-based offering, as soon as we implement the ICD-10 updates to the system, it is automatically deployed to you once you log in.
Updates to the system for regulatory mandates are included in your monthly subscription.
Kareo has upgraded both the Practice Management and the EHR software to include the following features.
- ICD-10 Success Dashboard
- Most Commonly Used Diagnosis Report
- ICD-9 to ICD-10 Crosswalk
- Dual coding
- Encounter Validation
- ICD-10 Look-up
Kareo will continue to enhance these features to provide our customers with the necessary tools to help them success with the ICD-10 transition.
Will I need new hardware to accommodate ICD-10-related software changes?
Good news, you won’t require any changes to your hardware system to support your Kareo software.
Will support for my current products continue after the transition to ICD-10?
As a cloud-based solution, your product is regularly updated and your support remains the same. We will provide timely updates to ensure that all our clients continue to meet all regulatory mandates.
How do I report issues, and how quickly will you respond?
All reported issues are handled in a timely manner and, as with any other issue it will be prioritized accordingly based on the severity and impact of the reported issue.
Who is my key contact?
Your current method for working with Kareo should remain the same.
What education tools are available for practices?
Kareo has several tools and references available on the ICD-10 Resource Center:
- ICD-10 Small Practice Guide, a guide to help navigate through the transition
- Kareo's ICD-10 Success Checklist, a convenient, step-by-step planning tool
- ICD-10 e-books, guides by specialty, for Mental Health, Pediatrics, Primary Care, OB/GYN, and Surgery practices
- ICD-10 on-demand webinars
Will you provide training on your software? What about other ICD-10 training?
You’ll have access to many forms of training to suit your practice. Live and recorded webinars, articles, and white papers are available.
Please note that it is recommended that your practice engage a vendor that offers ICD-10 coding training that is specific to your specialty or role. Kareo’s training sessions will be geared to address the general needs of all of its clients. Good resources include AAPC, AHIMA, and specialty societies.
Will you provide coding training for ICD-10?
Kareo has partnered with ICD-10 Success to offer ICD-10 Coding Classes and ICD-10 Documentation Classes. Through our partnership, we are able to provide this resource so you can get the training you need to be successful in the transition to ICD-10.
ICD-10 Success Training Programs provide a complete ICD-10 training solution for the entire staff. Educational videos combined with interactive games, documentation templates, and crosswalks are designed so that everyone in the practice understands their role in coding effectively for ICD-10.
You can select from a variety of courses for both your coders and staff. As a Kareo customer you will receive a $5.00 credit for each documentation course. To sign up:
- Go to this link: Kareo Access link.
- Click on Click Here to Join Us box in the right hand column
- Select the courses you wish to purchase.
- Review your order in Your Cart.
- Enter the Coupon Code KAREO and recalculate by clicking Apply.
- Payment is either by PayPal or as a Guest to PayPal you can use Visa, MasterCard or American Express.
- User will receive an email when the purchase is complete.
- From the email, they will have immediate access to the course.
For a list of courses and more information, read this blog post.
Will your product support dual coding?
The general industry mandate is for all coding to transition to ICD-10. However, Kareo does realize that there will be need to support both ICD-9 and ICD-10 for a period of time as necessary.
Will your product allow for coding in both ICD-9 and ICD-10 to accommodate transactions with dates of service before the deadline, and transactions with dates of service after the deadline?
Yes. ANSI 5010, CMS-1500 (02/12) and UB-04 were all designed with the idea that both versions will be needed as part of the overall transition.
Kareo provides a report to allow the practice to identify their most commonly used ICD-9 codes. Using this report and the crosswalk tool in Kareo, along with the ICD-10 Manual, you can map your top ICD-9 codes to their ICD-10 equivalents.
Kareo provides the ability to dual code without distributing workflow. At key points in the application, specifically encounter approve, superbill creation and problem lists, both the ICD-9 and ICD-10 may be viewed together.
Tools will be provided in upcoming releases to allow easy alphabetical searching for the appropriate code.
What code do I use after the deadline for services with dates of service prior to the deadline?
Even if you submit your claim on or after the deadline, if the date of service is before the deadline, then you will need to submit using ICD-9. For services on or after the deadline, you must utilize ICD-10.
How will your software assist providers with the assignment of ICD-10 codes?
Kareo provides a report to allow the practice to identify their most commonly used ICD-9 codes. Using this report and the crosswalk tool in Kareo, along with the ICD-10 Manual, you can map your top ICD-9 codes to their ICD-10 equivalents. Tools will be provided in upcoming releases to allow easy alphabetical searching for the appropriate code.
Please note that Correct Coding Initiative (CCI) Edits will not be impacted by the ICD-10 implementation.
How will our code scrubbing tool work with ICD-10?
The Coverage and Analysis Group at CMS is responsible for overseeing National Coverage Determination (NCD) and Local Coverage Determination (LCD) policies and they continue to publish updated ICD-10 policies at http://www.cms.gov/Medicare/Coverage/CoverageGenInfo/ICD10.html. They will continue updating and publishing the policies leading up to the October transition date. Our vendor partner responsible for updating our claim scrubbing edits is closely monitoring these changes and applying them where appropriate.
Please note that the Correct Coding Initiatives (CCI) Edits are not affected by the ICD-10 transition so there should be no impact to Mutually Exclusive, Comprehensive Component (unbundling) and Modifier Exclusion edits.
CPT-4 and HCPCS edits (proper use, crosswalks, modifier and effective date validation) will also be unaffected by the transition.
We heard that non-specific codes will no longer be allowed in ICD-10. Is this true?
Actually, non-specific codes do still exist in ICD-10. The fact that ICD-10 does offer a higher level of specificity does not resolve situations where the patient's condition cannot be coded to a more specific code. The key is that the provider's documentation continues to justify the use of the non-specific code.
Will Kareo offer coding assistance during the transition?
Kareo does not offer coding services today nor will we offer this service during the transition.
How do Multiple Codes in ICD-10 work?
There are three areas that control the number of diagnosis codes that can be submitted on a claim.
The electronic claim format
- ANSI 5010 837P: The majority of Kareo clients utilize this claim format and it currently supports up to 12 Diagnosis Codes per claim.
- ANSI 5010 837I Institutional: As far as our client base, this applies to Ambulatory Surgery Centers (ASC), Comprehensive Outpatient Rehabilitation Facility (CORF) and Outpatient Rehabilitation Facility (ORF).
Paper Claim Formats
- CMS-1500 (02/12): This new claims format allow support of up to 12 Diagnosis Codes, however, what has not changed is that each procedure will still only allow up to 4 diagnosis pointers. This means that this new form can still only support 4 diagnosis codes per procedure. If the claim has multiple procedure line items and have more than 12 unique diagnosis codes, then the claim will be split accordingly.
- UB-04: In the current state supports capture of a primary diagnosis code and up to 17 additional diagnosis codes.
Kareo Encounter Entry Screen
- Professional (837P or CMS-1500): Currently only supports the entry of 4 unique diagnosis codes per line item.
- Institutional (837I or UB-04): Supports as much as the claim format will support. Allows entry of Principal Diagnosis (required for all Institutional claims), Admitting Diagnosis (only required when a patient is admitted), “Other Diagnosis” which allows as many other diagnosis codes as the claim format will support.