CMS to Reimburse ICD-10 Mistakes for One Year
- By BSTQ Staff
In response to concerns by providers that they won’t be paid if they make minor mistakes under the transition from the ICD-9 to ICD-10 coding system, the Centers for Medicare and Medicaid Services (CMS) says it will reimburse for incorrectly coded claims for one year past the Oct. 1, 2015, deadline, as long as the erroneous code is in the same broad family as the right one.
The American Medical Association (AMA) teamed up with CMS to help make the transition easier for providers. A nationwide outreach effort to educate providers included webinars, onsite training, educational articles and calls to help physicians and other providers get up to speed before the Oct. 1 deadline. While the AMA previously supported a bill that would prohibit the U.S. Department of Health and Human Services from replacing ICD-9 with ICD-10, an AMA spokesperson said the change is “a culmination of a vigorous effort by medicine to ask the CMS for a transition period to avoid expected disruptions during this time of tremendous change in the healthcare landscape.”
CMS has also created the ICD-10 Ombudsman, as well as a host of online resources and guidance to aid the medical community. The guidance includes “Road to 10,” a website that contains a countdown clock and primers for clinical documentation, clinical scenarios and other specialty-specific resources to help with implementation.
The Medicare claims processing system does not have the capability to accept ICD-9 codes for dates of services as of Sept. 30, nor is it able to accept claims for both ICD-9 and ICD-10 codes. “The coming implementation of ICD-10 will set the stage for better identification of illness and earlier warning signs of epidemics, such as Ebola or flu pandemics,” said Andy Slavitt, acting administrator of CMS.
