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CODING

A clearinghouse isn’t the answer to ICD-10

Getting ready for ICD-10-CM

Don’t plan to rely on a clearinghouse to get the office through ICD-10-CM.

Clearinghouses can provide a lot of help, the government says, but not the same level of support they provided for the Version 5010 upgrade.

The reason is that ICD-10 is based on clinical documentation, and the coding requires medical knowledge as well as familiarity with the medical encounter. Thus, the diagnosis has to be selected by the provider or the provider’s coder.

The clearinghouse is limited in what it can do. It can help the office test its ICD-10 claim submission capability, it can identify what’s causing rejections, and it can show how to fix rejected claims. But unless it provides actual coding services, it cannot identify the correct ICD-10 codes.

And be aware that if it does have coding services, it will need access to all the clinical documentation.

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