Aetna Adds Software Recommendations To ICD-10 Prep List

Posted on 24 Sep, 2015 |comments_icon 0|By Chris Boucher

Check with EHR vendors for possible training programs.

There has been an abundance of guidance on how Medicare wants providers to prepare for ICD-10, which is set to be the accepted diagnosis coding system on Oct. 1. Most medical offices have been crafting their ICD-10 training on Medicare’s advice.

Don’t forget: Private insurers are also issuing their own advice on handling the transition from ICD-9 to ICD-10. You should check in on some of your private payers, as their policies on the ICD-10 transition might differ slightly from Medicare’s.

Private insurers might also focus on different areas from Medicare when it comes to ICD-10 training recommendations, so you’ll want to give their policies a once-over to round out your practice’s ICD-10 training.

Let’s take a look at Aetna, one of the nation’s largest third-party payers, to see what it had to say about transitioning to ICD-10.

Conduct ICD-10 ‘Overview Training’ For Some Staff

According to Aetna, the amount of ICD-10 training a staffer receives should be commensurate with their involvement in diagnosis coding.

“Clinicians and billing staff should receive documentation training and coding training, respectively, and other staff should have ICD-10 overview training,” Aetna states. The insurer recommends looking into local specialty societies and training vendors that offer specialty specific ICD-10 training. These training sessions can be done online or in person, depending on the program, Aetna reports.

Also, Aetna recommends you get in touch with your electronic health record (EHR) software vendors; many of them are partnering with training vendors to offer ICD-10 training tools.

Ensure That Software Converts ICD-10 To ICD-9

Aetna warns providers that all payers might not be ready for the ICD-10 switch. If this occurs, you’ll have to be able to adjust your diagnosis coding on the fly.

“In cases where a payer is not ready [for ICD-10 on Oct. 1], … you may need to submit a subset of your claims in ICD-9,” Aetna states.

To make sure you are ready for ICD-9 and ICD-10, Aetna recommends that your software vendor make ICD-9 codes available after the transition date.

“But to make the transition easier for your practice, you should be able to operate and code diagnoses in ICD-10, with your vendor converting claims to ICD-9 on your behalf for any payers not accepting ICD-10,” Aetna reports.

Read more advice on ICD-10 prep from Aetna at Medicare also has a robust ICD-10 preparation site:


Chris Boucher

Chris Boucher has nearly 10 years of experience writing various newsletters and other products for The Coding Institute. His blog will cover several areas of coding and compliance, including CPT® coding, modifiers, HIPAA compliance and ICD-10 coding.

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