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Free Fact Sheets: Common ICD-9-CM Codes and Possible ICD-10-CM Equivalents

Free Fact Sheets: Common ICD-9-CM Codes and Possible ICD-10-CM Equivalents

The ICD-10 deadline is here and Apex EDI realizes that you may need additional resources to help make the transition smooth. We have compiled three fact sheets identifying commonly used ICD-9-CM codes and matching them with their possible ICD-10-CM equivalents, one sheet for General Medicine codes, one for Ophthalmology codes, and one for Chiropractic codes.

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Please note this tool is not designed to provide perfect matches between the two coding systems. In fact, except for a minority of cases, perfect matches between the ICD-9-CM and ICD-10-CM coding systems do not exist. Given the significant increase in detail and specificity in the ICD-10-CM coding system, in most cases there is no direct match between ICD-9 and ICD-10 codes. A clinical analysis is required to determine which code or codes should be used. It is important to remember that even when there is only one ICD-10 code, it is not necessarily completely equivalent to the source ICD-9 code. This tool is not designed to replace proper training and documentation.

Proper coding begins with the doctor and documentation. While Medicare Part B is not going to deny claims based solely on the specificity of the ICD-10 diagnosis code as long as the codes are from the right family, they may pay less than what they have paid in the past based on the specificity of the diagnosis code. These tools are meant to shorten the amount of time spent looking up codes for best specificity. Most of the conversions identify the family where the appropriate crosswalk can be found. In the rare occasions where there is a direct crosswalk a clinical analysis is still required to determine if the crosswalk is appropriate for the billing situation.

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Medical Claims Clearinghouse

With all the regulation changes that have happened and have yet to happen, navigating the healthcare revenue cycle can be overwhelming. So much of what physicians do is overseen by one regulatory committee or another. In fact, often it is multiple committees that oversee one aspect of healthcare. Understanding what the healthcare professional needs to comply with can be costly. That is why having a medical claims clearinghouse on your side is a powerful partnership that no healthcare practice should be without.

In 2010 congress passed the Affordable Care Act (ACA). This law put into place numerous regulation changes. Some of those changes were obvious, like increased patients with insurance, others were not so obvious, such as insurance companies providing administrative and financial transactions that are compliant with the standards set forth. A medical claims clearinghouse is there to help manage these changes on behalf of the physician. They can help physicians by cutting through overwhelming documentation and let them know what they need to act on. They also maintain the relationship with the insurance company when it comes to the electronic interchange of data. This allows the medical claims clearinghouse to advocate for the provider when it comes to establishing connections for the administrative and financial transactions the insurance companies are now required to provide physicians. These transactions include, but are not limited to, electronic eligibility and benefit verification and electronic explanation of benefits (EOB’s).

With the ACA a number of regulatory bodies became prominent in the healthcare industry. One of those bodies is the CAQH body. They are responsible for the CORE operating rules. CORE operating rules are mandated operating rules in section 1104 of the ACA. The purpose of these operating rules is to:
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Apex EDI (Electronic Claims Processing) Integrates with My Vision Express Software

My Vision Express logo

(Salt Lake City, UT) March 28, 2014 — Apex EDI, is proud to announce their integration with My Vision Express (MVE) Electronic Health Records and Practice Management Software for Eye Care Professionals (ECPs), for electronic claims processing. More details will be released in the official press release March 28th at the Vision Expo East International Ophthalmic event.

This powerful integration allows MVE users to “click” and send claims electronically to Apex EDI, directly from their software. The interface also features an insurance portal to verify patients’ eligibility at the time of service verify claims status, and view and fix claim errors. Additionally, Apex and MVE are focused on facilitating ECPs efforts to meet the requirements of the ICD10 and EMR/meaningful use requirements. These new features will assist ECPs to reduce their accounts receivable and streamline claims management, enabling them to focus on providing patient care.

“We are excited to provide Apex EDI insurance clearinghouse services with our software,” said Vipul Katyal, President, My Vision Express. “Together we are providing better solutions that provide exceptional value to the eye care industry!”

“My Vision Express software continues to demonstrate the power of innovative software. We are excited to offer our services as part of their integrated solution to optometry providers,” said Sheldon Miner, Chief Executive Officer of Apex EDI.

ABOUT APEX EDI

Apex EDI is a leading healthcare claims clearinghouse for medical and optometric professionals. Apex EDI serves thousands of physicians, optometrists, and other medical providers nationwide with its Apex OneTouch® solution. The OneTouch® solution is a Web-based electronic claims reimbursement system that increases productivity and profitability while facilitating fast payment of insurance claims and providing additional reporting and analysis. For more information about APEX EDI, visit: www.apexedi.com/mve. (800 840-9152)

About My Vision Express

My Vision Express was designed exclusively for optometrists, ophthalmologist, and opticians who want to boost the efficiency and growth of their practices. My Vision Express features a comprehensive EHR, innovative POS, and many powerful inventory, business, marketing, and staff management tools and attest for Meaningful Use Stages 1 and 2.

Multiple licensing options are available with My Vision Express, from single computer users to multiple computer users across multiple locations, so there is a solution for every type of practice. My Vision Express is easily accessible on the devices you currently own – Windows, Macs, iPhone, iPad, Android, and Kindle – enabling you to manage your practice from anywhere and is available as both Cloud and in-office server solutions.

My Vision Express offers a free 30-day trial of the software. Contact 1-877-882-7455 or visit www.MyVisionExpress.com for more information.

My Vision Express
3050 Universal Blvd, Suite 120 – Weston, FL 33331
1.877.882.7455 – Sales@myvisionexpress.com

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USPS Postage Rate Increase 2014

As of January 26, 2014 a US Postal Service rate increase will come into effect. As postage rates go up, Apex EDI will still process your statements for a low price with just a three cent increase to cover the higher postage.

The cost of Statements as of February 1, 2014 will increase to 70¢ for the first page. Second pages will still cost only 19¢.

The Apex system makes it easy to generate and print clear, professional statements complete with postal bar coded envelopes. With just a few simple steps statements can be generated every day so you can receive patient payments more quickly. In addition, once all of the hidden costs of printing and mailing statements in house are identified (paper, toner, envelopes, stamps, and the time spent printing, folding, stuffing, and mailing), it’s easy to see that you will recognize a significant cost savings in sending statements electronically. View a sample statement and a demo video here.

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RevolutionEHR Announces Integration with Apex EDI for Electronic Claims Processing

RevolutionEHR Logo

(Madison, WI) June 12, 2013 — RevolutionEHR, the leading provider of cloud-based practice management and electronic health record (EHR) software for the optometric community, is pleased to announce integration with Apex EDI, for electronic claims processing.

The integration will allow RevolutionEHR practices to submit insurance claims electronically directly from RevolutionEHR via Apex to payers. Apex EDI will then provide each practice with reporting and web based claims management functions to streamline the billing process.

“We are pleased to provide Apex EDI as another option for customer claims processing needs,” said Scott Jens, DO, FAAO, Chief Executive Officer of RevolutionEHR. “The integration will further enhance our dedication to building relationships with industry partners who have the same drive that we do, which is to improve patient care.”

Apex EDI also provides RevolutionEHR practices with a unique “two-minute” submission process, which combines personal, fast and capable service for insurance claims.

“At Apex EDI, we are very excited to partner with RevolutionEHR,” said Sheldon Miner, Chief Executive Officer of Apex EDI. “Our strengths of outstanding user support provides RevolutionEHR practices with a complete revenue product, especially for those looking toward implementing an EHR and ICD-10 changes.”

RevolutionEHR recognizes optometrists are interested in improving patient care, easing workflow and implementing best practices for patient outcomes. The Apex EDI integration will provide another added benefit for RevolutionEHR customers.

ABOUT APEX EDI

Apex EDI is a leading healthcare claims clearinghouse for medical and dental professionals. Apex EDI serves thousands of physicians, dentists, and other medical providers nationwide with its Apex OneTouch® solution. The OneTouch® solution is a Web-based electronic claims reimbursement system that increases productivity and profitability while facilitating fast payment of insurance claims and providing additional reporting and analysis. For more information about APEX EDI, visit www.apexedi.com/revolutionehr.

About RevolutionEHR

RevolutionEHR is the leading provider of cloud-based practice management and electronic health record systems for the optometric community. RevolutionEHR is an online solution that provides optometrists the freedom to focus on patient care. For more information about RevolutionEHR, visit www.revolutionehr.com, or contact Cindy Braden at (877) 738-3471.

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