ICD-10 AWARDS Integration

Even though the required changeover from ICD-9 to ICD-10 has been delayed until October 1, 2015, Foothold is ready to accommodate this switch.  For all clients using the BillingBuilder module in AWARDS, let’s talk about your options.

First, payers could require ICD-10 billing codes on different dates.  To handle this situation, we have added a new data field within the Configure Payers screen of the BillingBuilder module called ICD-10 acceptance date.  Use this date to identify when your payers have indicated they will be ready to receive ICD-10 billing codes.

Second, a brief conversation about the procedures being billed to your payers.  During this transition period, your consumers may have a DSM-IV and DSM 5 diagnosis assigned to them.  To ensure that the expected ICD-9 or ICD-10 billing code is used, we have included new options within the Configuration of Billing Types screen of the BillingBuilder module.  These new options are part of the Which Axis to use option and are listed below with descriptions:

• Axis I (not after 10/1/2015) – select this check box if invoices are to bill using an axis 1 diagnosis (DSM-IV).
• Axis II (not after 10/1/2015) – select this check box if invoices are to bill using an axis 2 diagnosis (DSM-IV).
• No DSM IV Axis (on or before 10/1/2015) – check this box if a DSM-IV axis should NOT be used for billing invoices.
• DSM 5 (on or before 10/1/2015) – This box is not directly associated with the first three radio button selections.  Check this box, to bill off of a DSM 5 diagnosis, if one exists in a consumer’s diagnosis record.

Lastly, we’ll wrap up mentioning a couple of new data changes when entering a diagnosis for a consumer.  To best assign a diagnosis to an invoice being billed out of AWARDS, there are three data elements being used in addition to the configuration options mentioned above:

• Diagnosis Date – this date needs to be on or before the service/invoice date to allow a diagnosis code to be used for billing.
• Resolution Date – this date needs to be on or after the service/invoice date to allow a diagnosis code to be used for billing.
• Use for Billing – this check box needs to be checked to allow a diagnosis code to be used for billing.

As your agency moves into configuring these changes and you have questions, please feel free to review our AWARDS online help documentation using the link provided below or reach out to you Senior Customer Success Manager for guidance.