Oct. 1 ICD-10 implementation deadline arriving

by Marilyn Rissmiller, Senior Director, Division of Health Care Financing

Federal CMS names “ICD-10 ombudsman”
With less than one month to go before the Oct. 1 implementation deadline for ICD-10, the Centers for Medicare and Medicaid Services is working to provide additional clarity and assistance for physicians.

The agency has named an “ICD-10 ombudsman,” emergency room physician William Rogers, who currently serves as director of the agency’s Physicians Regulatory Issues Team. In this role, he will be a “one-stop shop” for physicians with questions and concerns and will serve physicians as their advocate within the agency, said federal CMS Acting Administrator Andy Slavitt on a national provider call. Physicians can contact Dr. Rogers via email at icd10_ombudsman@cms.hhs.gov.

The agency also announced that its new ICD-10 Coordination Center in Baltimore will begin operating at the end of September. The goal of the center will be to “manage and triage issues” relating to the transition from the ICD-9 code set.

Both provisions were included in an agreement the American Medical Association and federal CMS announced in July. That agreement established an ICD-10 grace period to help make the transition less disruptive to physician practices.

The idea for the grace period originated with the Colorado delegation to the AMA and was passed at the AMA Annual Meeting in June. It assures that, for the first year ICD-10 is in place, Medicare Part B claims will generally not be denied solely based on the specificity of the diagnosis codes as long as they are from the appropriate family of ICD-10 codes.

Agency releases final round of testing results
About 1,200 physicians and other health care professionals participated in the federal CMS’s final end-to-end testing week in late July. The acceptance rate for July was similar to rates in the previous two testing weeks.

Here are the final end-to-end testing numbers:

  • 29,286 test claims received.
  • 25,646 test claims accepted.
  • 87 percent acceptance rate.
  • 1.8 percent of test claims were rejected as a result of an invalid submission of ICD-10 diagnosis or procedure code.
  • 2.6 percent of test claims were rejected as a result of an invalid submission of ICD-9 diagnosis or procedure code.

The agency suspects that some testers intentionally included errors to make sure the claim would be rejected. Additional rejections were from non-ICD-10-related errors, including incorrect National Provider Identifiers, health insurance claim numbers or submitter IDs, dates of service outside the range valid for testing, or invalid place of service.

Still time to prepare
Though time is running out, there are still steps practices can take to be ready for the transition to ICD-10. The AMA and federal CMS have resources to polish a practice’s implementation plan over the next few weeks.

  • A free online module in the AMA’s STEPS Forward collection that offers materials to help you prepare. Access it at www.stepsforward.org/modules/ICD-10-implementation-plan.
  • A special series at AMA Wire examines what you need to do each month to prepare for the transition, whether you’re an ICD-10 expert or just getting started. Access it at www.ama-assn.org/ama/ama-wire/blog/ICD-10_Monthly_Primer/1.
  • Additional ICD-10 content at AMA Wire provides important insights for what you need to know about the new code set. Access it at www.ama-assn.org/ama/ama-wire/blog/ICD-10/1.
  • The AMA’s ICD-10 webpage offers important information and resources on implementation planning, from cross-walking between ICD-9 and ICD-10 to testing your readiness. Access it at www.ama-assn.org/go/icd-10.
  • The federal CMS is offering free assistance for smaller physician practices through its “Road to 10” website. This collection includes primers for clinical documentation, clinical scenarios and other specialty-specific resources to help with implementation. Access it at www.roadto10.org.

Categories: Communications, Colorado Medicine, Resources, Practice Management, Coding and Billing