October 1st ICD-10 Transition Nears

Coding Corner

The information provided here applies to Medicare coding. Be sure to check with your Medicare Administrative Contractor (MAC) for additional information and clarification on these and other items. You should also contact your local insurance carriers to determine if private insurers follow Medicare's lead on all coding matters.

October 1st ICD-10 Transition Nears

With the introduction of legislation in Congress and prior postponements, I was beginning to wonder if the transition to the new International Classification of Diseases, 10th Edition, Diagnosis and Procedure Codes (ICD-10) was ever going to happen. Following a recent joint announcement by the American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS), it appears all but certain that the transition to ICD-10 will take place on October 1.
In the joint statement, CMS and the AMA outlined a transition plan over the next few months that will include the release of webinars and other educational materials to help providers make the transition from ICD-9 to ICD-10.  In addition to the release of educational resources, CMS has agreed to name an ICD-10 ombudsman to help physicians and providers with issues that arise out of the transition to the new code set. 
As outlined in the joint statement, it appears that for the first 12 months of ICD-10 use there will be an allowance for a degree of non-specificity.  Specifically, as part of the transition to ICD-10 coding, CMS may not deny claims billed under Medicare Part B that use a wrong ICD-10 code so long as the code is in the right category. Similarly, there will be no penalty under quality reporting programs for use of an incorrect code that is from the correct category.  You can learn more by visiting https://www.cms.gov/Medicare/Coding/ICD10/Clarifying-Questions-and-Answ… .

If you have been waiting for a sign that ICD-10 will be implemented on October 1, 2015, consider yourself on notice.  If you have not started preparing, it is imperative that you do so immediately.

Stay True to Why You Pursued Medicine.