When Congress enacted the Protecting Access to Medicare Act of 2014, it also delayed the implementation of ICD-10 for at least a year. While the Centers for Medicare and Medicaid Services “is examining the implications of the ICD-10 provision and will provide guidance to providers and stakeholders soon,” according to their website, this latest delay is expected to cost the healthcare industry up to $6.6 billion (in addition to what last year’s delay already cost), according to the American Health Information Management Association.

“The delay in implementation of ICD-10 will be welcomed by many ophthalmologists,” said Michael X. Repka, MD, medical director for governmental affairs at the American Academy of Ophthalmology. He said the group would concentrate its efforts on other anticipated regulations.

Kevin J. Corcoran, president of Corcoran Consulting Group, said one faction of ophthalmology believes they’ve already spent enough time and money and that implementation should have already been enacted (adding 198 of 200 countries have already adopted the World Health Organization’s ICD-10, with the U.S. and Italy being the two main holdouts). Another faction is ambivalent about the fate of ICD-10, and a third faction believes ICD-10 will never be implemented.

ICD-10 requires more information to select an appropriate code. For example, it’s important to know how an injury occurred, Mr. Corcoran said. For instance, if an elderly patient presents with a traumatic cataract that was the result of a car accident, ICD-10 instructs“Use additional code (Chapter 20) to identify external cause,” such as “car driver injured in collision with other type car in traffic accident.” As a result of the ICD-10 code selection, Medicare shouldn’t pay the claim, because one of the driver’s auto insurance is responsible for payment.

Here are some quick tips on what practices should be doing now to get ready for ICD-10.

1. Code in ICD-10, bill in ICD-9. Use your electronic medical record and practice management system to get comfortable with ICD-10. When it’s time to submit a claim for reimbursement, convert the selected ICD-10 code back to ICD-9. By building your skills now, you’ll be better prepared to “go live” when the time comes.

2. Use the grace period to learn the codes. ICD-10 includes significantly more granularity than ICD-9, and the number of codes has increased from about 14,000 to 69,000, Mr. Corcoran said. For example, in ICD-10, there’s a unique code, E11.359, for “Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema.”

“Practices need to capture all of this information,” he said. Further, in ICD-9, glaucoma staging was reported with a separate code, 365.7x, but in ICD-10, disease severity is combined with the type of glaucoma. For example, H40.1233 is “Low-tension glaucoma, bilateral, severe stage.”

3. Improve charting. “You can’t code what’s not in the charts. Absent the required information, the billers’ hands are tied,” Mr. Corcoran said. When physicians in Australia and New Zealand began to implement ICD-10, about half the charts couldn’t be coded as written.

“If we’re going to learn anything from that experience, it’s that we’ve been given a grace period to modify behavior and improve the [quality and detail of] information collected from patients during the initial presentation,” said Mr. Corcoran.