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July 2015
In this Issue

  • Countdown Continues to ICD-10 Switchover

    While ISMS remains strongly opposed to ICD-10 implementation, the Centers for Medicare and Medicaid (CMS) continues to move forward with implementation of the new code set – while also demonstrating some responsiveness to physician concerns.  

    CMS recently agreed to an AMA-supported one-year “grace period” that includes these key elements: 

    • As long as physicians submit ICD-10 codes from an appropriate “family of codes,” Medicare claims will not be denied for the year following Oct. 1, 2015. (In other words, if a correct code from the broad topic of choices is used to describe a diabetic condition or a wrist fracture, for example, it will not be denied, even if not coded to the correct level of specificity.)

    • An ICD-10 ombudsman will be established to triage problems that need to be resolved during the transition.

    • For CMS’ quality programs for the 2015 reporting year, physicians using the appropriate family of diagnosis codes will not be penalized if CMS experiences difficulties in accurately calculating quality scores.

    • CMS will authorize advanced payments if Medicare contractors are unable to process claims within established time limits due to problems with ICD-10 implementation.

    Please note: Use of ICD-9 after October 1 will result in no payments and in claim denials.

    For help with completing your preparation, visit ISMS’ ICD-10 webpage, and check out AMA and CMS resources. Also access CMS’ Road to 10: The Small Physician Practice's Route to ICD-10.

    Questions? Call your ISMS Advocacy Team at 800-782-4767 ext. 1470 or send an email.

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