An AMA Viewpoints post by AMA President Steven J. Stack, MD.
Implementation of the ICD-10 code set is just around the corner, with a hard deadline of Oct. 1. Many physicians have been concerned about adopting this code set because of the heavy investment of time and resources and the potential for claims disruptions that could interfere with patient care.
Fortunately, the AMA has secured provisions that will ease this transition, particularly for physicians in practices with limited resources.
In response to our extensive communication of physicians’ concerns, the Centers for Medicare & Medicaid Services (CMS) announced today (7/6/15) that it is making several critical changes to the transition period so that physicians can continue to provide high-quality patient care without risking their livelihood.
These changes address:
• Claim denials. For the first year ICD-10 is in place, Medicare claims will 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.
This means that Medicare will not deny payment for these unintentional errors as practices become accustomed to ICD-10 coding. 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 transition period will give physicians and their practice teams time to get up to speed on the more complicated code set.