Are you ready?
There are less than three months until the nation switches from ICD-9 coding to ICD-10 coding for medical diagnoses and inpatient hospital procedures. The International Classification of Diseases has not been updated in more than 35 years, and use of ICD-10 by October 1, 2015, is required for everyone covered by the Health Insurance Portability Accountability Act.
The Centers for Medicare & Medicaid Services and the American Medical Association have announced measures to assist physicians in the transition to ICD-10 coding.
The CMS and AMA will be educating providers through webinars, on-site training, educational articles and national provider calls to help physicians and other health care providers learn about the updated codes and prepare for the transition. An ombudsman will be available via the online ICD-10 Coordination Center to answer questions about the submissions of claims.
Planned implementation milestones include:
- July: Sending a letter to all Medicare fee-for-service providers encouraging ICD-10 readiness and notifying them of these flexibilities.
- July: Completing the final window of Medicare end-to-end testing for providers.
- Aug. 27: Hosting an MLN Connects national provider call.
- Through September 30: Offering ongoing Medicare acknowledgement testing for providers.
- Providing additional in-person training through the “Road to 10” for small physician practices.
The CMS claims processing systems will not have the capability to accept ICD-9 codes for dates of service after September 30, 2015, nor will they be able to accept claims for both ICD-9 and ICD-10 codes.
“We appreciate that CMS is adopting policies to ease the transition to ICD-10,” AMA President Steve J. Stack MD said in a July 6 press release, “in response to physicians’ concerns that inadvertent coding errors or system glitches during the transition to ICD-10 may result in audits, claims denials, and penalties under various Medicare reporting programs.”
Additional resources:
- ICD-10 Coordinator Center on the CMS website
- Frequently asked questions (pdf)
- Road to 10: Small physician practice’s route to ICD-10 (CMS website)
- CMS to make ICD-10 transition less disruptive for physicians (AMA Wire, 7/6/15)
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This publication is for general information only. It is not legal advice, and legal counsel should be contacted before any action is taken that might be influenced by this publication.
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