Don't Let Inactive ICD-10 Codes Derail Your Claims

Deprecated or inactive ICD-10 codes refer to codes that have been replaced or updated by newer versions. These codes are no longer valid for usage in claims processing and can lead to denials if not properly updated. The Centers for Medicare and Medicaid Services (CMS) https://www.cms.gov/ regularly updates the ICD-10 code set to reflect changes in medical practice, new technologies, and emerging health trends.

The Consequences of Using Deprecated ICD-10 Codes
Using a deprecated ICD-10 code on a claim is basically telling the payer that the diagnosis no longer exists or is no longer relevant. This immediately raises red flags and leads to claim denials, delayed payments, and increased administrative burdens. When a deprecated code is used, the claim is likely to be rejected, requiring resubmission with the updated code. This can lead to:

• Delayed reimbursement: Claims with deprecated codes are often rejected or processed slowly, leading to delayed payments
  
• Increased administrative costs: Correcting errors and resubmitting claims takes time and resources
  
• Reduced productivity: Staff time is wasted on managing denied claims instead of focusing on patient care
  
• Negative impact on patient care: Delayed payments can affect a practice's ability to invest in new equipment, technology, or staff, ultimately impacting patient care.
  
  

How to Prevent Denials Due to Deprecated Codes

1. Regularly Check the ICD-10 Portal: The AAPC website provides a comprehensive ICD-10 portal that lists updated codes, deleted codes, and code changes. Regularly checking this portal can help ensure that your coding is current. (eg. https://www.aapc.com/codes/icd-10-codes-range/)
2. Verify Codes Manually: In addition to checking the portal, it is crucial to manually verify codes against the latest ICD-10 manual or coding resources. This ensures that any updates or changes are captured.
3. Update Coding Systems: Ensure that your electronic health record (EHR) system, practice management systems (PMS), and other coding tools are updated with the latest ICD-10 codes.
4. Train Your Staff: Provide ongoing education and training to coding and clinical staff on the importance of accurate and up-to-date coding.

The Bottom Line
By understanding the nuances of ICD-10 codes and implementing effective prevention strategies, you can significantly reduce the number of claim denials related to deprecated codes. Remember, staying informed and vigilant is key to maintaining clean claims and optimizing your revenue cycle.

By following these steps and staying vigilant about ICD-10 code updates, you can significantly reduce claim denials and optimize your revenue cycle.  For a more comprehensive review of your coding practices and to ensure you're maximizing reimbursement, contact Claims Med today! Our team of experienced medical billing and coding specialists can help you navigate the complexities of ICD-10 coding and ensure your claims are processed smoothly.