Colorado Medical Societyhttp://www.cms.org/articles/icd-10-news-round-up-one-week-remains/
ICD-10 news/resource round upWednesday, September 23, 2015 08:29 AM
Webinar: Documentation Excellence: ICD-10 from a Physician’s Perspective
The Colorado Medical Society and Colorado Access teamed up to present “Documentation Excellence: ICD-10 from a Physician’s Perspective” at various locations along the Front Range in August and September. View the webinar version of this seminar (40 minutes) here. Download the accompanying slides here.
Clarification on ICD-10 flexibilities
On July 6, 2015, the Centers for Medicare and Medicaid Services and the American Medical Association released a joint statement about their efforts to help the provider community get ready for ICD-10, an idea that originated with the Colorado delegation to the AMA. This statement included guidance from CMS that allows for flexibility in the claims auditing and quality reporting processes. In response to questions from the health care community, CMS has released updated “Clarifying Questions and Answers Related to the July 6, 2015 CMS/AMA Joint Announcement and Guidance Regarding ICD-10 Flexibilities,” which provides answers to the most commonly asked questions. Today CMS has reissued these questions and answers with revisions to questions 1 and 9, as well as 9 new questions and answers. Click here to access the document.
Resources from the Centers for Medicare and Medicaid Services
To help physicians prepare their practices, the Centers for Medicare and Medicaid Services released an infographic to help practices successfully bill for services. It asks questions and links to resources regarding testing, coding and documentation. “If your systems are not ready and you are unable to submit claims with ICD-10 codes, now is the time to explore your options for submitting ICD-10 claims,” the federal CMS said in an email release. Click here to view the infographic.
CMS also has an ICD-10 quick start guide that outlines five steps practices should take to prepare for ICD-10. Click here to view the guide.
And, this MLN Matters bulletin delineates claims submission alternatives for providers who have difficulties submitting ICD-10 claims.
ICD-10 claims problems
Identify the source of the problem: Originating site (entry, practice management system); transmission (practice management system, clearinghouse, payer); processing system (payer); and triage accordingly.
The federal CMS has provided an ICD-10 Ombudsman to address ICD-10 related issues. Email email@example.com.
Many resources are available to assist providers with the transition, including the CMS ICD-10 website at www.cms.gov/Medicare/Coding/ICD10/index.html, including Frequently Asked Questions the CMS ICD-10 Quick Start Guide and the Road to 10: CMS Online Tool for Small Practices.
Private payer information
- Anthem ICD-10 FAQ and training tools
- Aetna ICD-10 FAQ
- CIGNA ICD-10 FAQ
- Humana ICD-10 FAQ
- Rocky Mtn. Health Plans Summer Bulletin included ICD-10 information
- UnitedHealthcare ICD-10 FAQ also have training tools on website
Use of unspecified codes in ICD-10-CM
The federal CMS has a number of resources that explain unspecified codes and how they should be used in ICD-10-CM:
- MLN Matters® Article SE1518, “Information and Resources for Submitting Correct ICD-10 Codes to Medicare”
- ICD-10 Basics MLN Connects National Provider Call - Call Materials from August 22, 2013
- More ICD-10 Coding Basics MLN Connects Call - Call Materials from June 4, 2014
- ICD-10 Coding Basics MLN Connects Video - January 2014
- Coding for ICD-10-CM: More of the Basics MLN Connects Video - December 2014
Visit the ICD-10 Medicare Fee-For-Service Provider Resources webpage for a complete list of Medicare Learning Network educational materials.
Colorado Workers’ Compensation
Physicians who treat injured workers through the Colorado Workers’ Compensation program may not need to be fully ICD-10 compliant by Oct. 1. The department is encouraging providers to work with the payers to see when they both will be ready for ICD-10. Pinnacol has confirmed that they will be able to accept ICD-10 by Oct. 1.
Practices should use the CMS 1500 billing form, but because version 02/012 carries both ICD-9 and 10, the department says this gives both providers and payers the flexibility to work together in implementing ICD-10 as it is rolled out in other insurance and health care systems.
Payers cannot deny payment for billed services purely based upon billing or not billing ICD-9 or ICD-10. Workers’ comp Rule 16-6 (E) says, “The payer should note that the current in-effect International Classification of Diseases (ICD) codes, when submitted, shall not be used to establish the work relatedness of an injury or treatment.” The ICD-10 PCS will be necessary in order to apply the DWC’s 2016 inpatient PPS hospital medical fee schedule under the version #33 MSDRG system.
The American College of Emergency Physicians (ACEP) has targeted its ICD-10 resource development to focus on changes in documentation requirements rather than how to assign codes. The material can be found on the ACEP website here. They have also been releasing daily tweets giving a short tip in ICD-10 documenting the required specificity to help coders chose the most accurate diagnoses code.
The American College of Cardiology has posted ICD-10 resources on its website. Find them here.