Many offices have contacted us regarding ICD-10 over the last few years. Lately these requests for help have become more ernest. While I have traditionally told people that I didn't believe it was the year for ICD-10 to FINALLY become mandatory, all signs are currently pointing to "yes" for this year. I will still hold out till Oct 1 to be certain BUT it is still good to be prepared.
In July Medicare announced that It will not deny claims coded with ICD-10 that don't use high specificity...at least not at first. That means that if you have the ability to translate an icd-9 code to an icd-10 code directly, not highly specific in terms of ICD-10, you will likely not receive a denial for that. However, this is a temporary solution so you shouldn't rest on your laurels.
Here is an excerpt of the original announcement put out by Office Ally:
"According to the CMS, for one year after Oct. 1, 2015, Medicare will not deny physicians or other practitioners Part B claims based solely on the specificity of the ICD-10 diagnosis code as long as the provider used a valid ICD-10 code from the right family. In addition, quality reporting will also receive a grace period, as long as a valid ICD-10 code from the correct family of codes is used. Moreover, if a Part B MAC is unable to process claims within established time limits because of administrative problems, an advance payment may be available. CMS will also have an ICD-10 Ombudsman to help receive and triage provider issues. "
I still do not believe that it is in our best interest to implement ICD-10 while the rest of the world is already moving to ICD-11 but that is a different argument for a different day.
Click here to learn more about the CMS/AMA announcement.
Click here for the guidance/FAQ from CMS.
opticXpress is an optometric billing company that provides a clearinghouse, billing service and software strictly for optometrists.
