On July 6, 2015, the Centers for Medicare and Medicaid Services (CMS) and the American Medical Association announced a grace period for the Oct. 1, 2015 implementation of the ICD-10 diagnosis code set.
For a one-year period starting Oct. 1, Medicare claims will not be denied solely on the specificity of the ICD-10 diagnosis codes provided, as long as the physician submitted an ICD-10 code from an appropriate family of codes. In addition, Medicare claims will not be audited based on the specificity of the diagnosis codes as long as they are from the appropriate family of codes. This policy will be followed by Medicare Administrative Contractors and Recovery Audit Contractors.
To avoid potential problems with mid-year coding changes in CMS quality programs (PQRS, VBM and MU) for the 2015 reporting year, physicians using the appropriate family of diagnosis codes will not be penalized if CMS experiences difficulties in accurately calculating quality scores (i.e., for PQRS, VBM, or Meaningful Use). CMS will continue to monitor implementation and adjust the duration if needed.
CMS will establish an ICD-10 Ombudsman to help receive and triage physician and provider problems that need to be resolved during the transition.And CMS will authorize advanced payments if Medicare contractors are unable to process claims within established time limits due to problems with ICD-10 implementation.
The October 1 deadline for implementation of the ICD-10 code set is fast approaching, and time is running out for physician practices to complete their preparation. The AAO has a broad range of materials available on its web site to help physicians prepare for the deadline. To learn more, go to the federal CMS website.
This site was created to help physicians navigate requirements of the International Classification of Diseases, 10th Revision (ICD-10) code sets. ICD-10 includes nearly 55,000 more codes than the previous version, which will require changes to how health care information is collected, documented and used, both within your practice and outside.
We recognize that each physician’s office is different and will need a tailored plan for your needs. Use the navigation boxes above to go step-by-step through the process and forge your pathway through the ICD-10 maze.
About the Colorado ICD-10 Training Coalition:
The Colorado Medical Society has orchestrated the formation of a statewide training coalition of interested educators, consultants, physician/practice representatives (including members of the component medical societies, and Colorado Medical Group Management Association, Pikes Peak Chapter of the Professional Association of Health Care Office Management, Colorado Health Information Management Association), the Denver Regional Office of the Centers for Medicare and Medicaid Services, and other stakeholders. We all share the goal of ensuring physicians and their staff are prepared for the implementation of ICD-10 on Oct. 1, 2014.
The statewide training coalition will make ICD-10 resources and training accessible to physicians and their staff via an organized multi-media educational campaign. Through a modular approach the coalition will provide a progressive training curriculum. A modular approach will allow practices to do much of the preparatory work now, such as project planning, impact analysis and documentation evaluation. It does not replace the need for intensive coding training, but it can be “put off” until early 2014 when the actual implementation is closer.
The coalition is open to any organization or individual who shares our goal of providing an organized, affordable approach to statewide ICD-10 training for physicians and their staff, and is willing to provide their time, talent and resources to this effort. Click here to see the current list of members and to join or pledge to be ready by Oct. 1, 2015.