Freed Associates

CMS And AMA Come Together To Help With ICD-10 Transition

TOPIC: Health Reform 2.0, Information Technology

The ICD-10 transition is coming fast. Even though summer is in full swing, we can feel the first hints of fall, and with it, the October 1st deadline to transfer from ICD-9 to ICD-10. This has the potential to be confusing for providers and administrators, but luckily, the Center for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) have come to an agreement in mutual support for transitioning to ICD-10. This is good news for everyone involved, and it is important to know what help will be provided.

Three Core Messages From The CMS Memo

CMS emphasized three key points about the ICD-10 medical coding system transition and the help they’ll offer providers. They know the kind of questions that providers will be asked and have some answers to help out.

  1. An ICD-10 Command Center. Rather than going through disparate channels to get the answers you need, CMS has created a command center; a central Ombudsman to support the ICD-10 issues a physician might have. Think of it as a triage unit for confusion.

  2. ICD-10 Learning Curve Concessions. With a new system comes understandable errors, such as entering the wrong code. However, doing so won’t incur a denial of payment from Medicare administrators, who have been instructed to give leeway for one year post-implementation. As long as the physician is using the ICD-10 code set and the code is within the family, they will still receive payment.

  3. Advanced payment. If Medicare doesn’t follow the prompt payment guidelines due to system issues, you can receive an “advanced payment.” This is a conditional partial payment, and must be repaid.

Important Points To Remember

While these new support measures should ease the transition process for everyone, it’s still important to keep the following in mind:

  • The October 1st deadline is a hard one; there aren’t any indications of an extension for implementation.

  • You have the one-year grace period to get used to the new system, so integrating perfectly on the first day isn’t necessary or expected. However, the sooner you can solidify your new ICD-10 coding system, the better.

  • Communication with the ICD-10 Command Center of your commercial provider and with your Medicare provider is key. Everyone is adjusting, so keeping in touch and making sure everyone stays on the same page is extremely important.