ICD-10 Alert: CMS and AMA Offer New ICD-10 Initiatives to Help Providers Transition

New ICD-10 Initiatives to Aid in Transition

In a July 6th press release the US Center for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) announced new ICD-10 initiatives to help providers successfully transition by the looming October deadline.

The press release announced an increase in flexibility in the enforcement of ICD-10 rules to help providers transition by the October 1, 2015 deadline. Providers will be reimbursed for incorrectly coded claims for one year after the October 1, 2015 deadline, as long as the incorrect codes are used from the “appropriate family” of ICD-10 codes. This does not delay the deadline and providers are still responsible for using complete and accurate ICD-10 codes by October 15, 2015.

The new ICD-10 code system is more advanced than the old ICD-9 code set, and has been expanded to include seven positions instead of five. It contains over 55,000 new codes to allow for an increase in specificity in reporting. The change will affect multiple parts of a medical practice, including processes, systems, and staff. The American Medical Association (AMA) and US Center for Medicare and Medicaid Services (CMS) have released initiatives to help with the transition from the old system to ICD-10.

Ease the Transition to ICD-10

Additional initiatives, in addition to reimbursing wrong codes for a year after the transition deadline, include:

  • CMS will not penalize providers who are trying to meet various quality standards for any errors made in reporting what treatments were given patients as part of that “quality care.” This applies to the Physician Quality Reporting System, the value-based payment modifier, and to “meaningful use” standards for implementing and using computerized medical records.
  • CMS will not delay reimbursement payments to providers due to claims processing issues; “CMS will authorize advance payments to physicians,” in these situations, stated AMA President Steven Stack, MD.”
  • CMS will establish an ICD-10 communications and coordination center that will include an ombudsman to deal with any problems or issues providers experience in working with the new code set including claims submission.
  • CMS and AMA will offer ICD-10 provider education webinars, onsite training, and educational articles.
  • CMS will host a national provider call on August 27, 2015 from 2:30pm – 4:00pm EST. Additional information and registration is available.
  • ICD-10 acknowledgement testing will be available through September 30th.

The full July 6th CMS press release contains more information about the transition.