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Provider ICD-10 Announcements
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ICD-10 Announcements 

  1. September 28, 2015
    1. ICD-10 Presentation
       
  2. July 30, 2015
    1. Countdown to ICD-10
      Clarifying Questions and Answers Related to CMS/AMA Joint Announcement and Guidance Regarding ICD-10 Flexibilities
      On July 6, 2015, CMS and the American Medical Association (AMA) released a joint statement about their efforts to help the provider community get ready for ICD-10. This statement included guidance from CMS that allows for flexibility in the claims auditing and quality reporting processes.
      In response to questions from the health care community, CMS has released Clarifying Questions and Answers Related to the July 6, 2015 CMS/AMA Joint Announcement and Guidance Regarding ICD-10 Flexibilities, which provides answers to the most commonly asked questions.
      Visit the CMS ICD-10 website and Roadto10.org for the latest news and resources to help you prepare.

      MLN Connects National Provider Call: Countdown to ICD-10

      Thursday, August 27; 2:30-4pm ET
      To Register: Visit MLN Connects Event Registration. Space may be limited, register early.
      Don’t miss the August 27 MLN Connects Call — five weeks before ICD-10 implementation on October 1, 2015. Sue Bowman from the American Health Information Management Association (AHIMA) and Nelly Leon-Chisen from the American Hospital Association (AHA) will be joining us with coding guidance and tips, along with updates from CMS.

      Agenda:
      • National implementation update
      • Coding guidance, AHA and AHIMA
      • How to get answers to coding questions
      • Claims that span the implementation date
      • Results from acknowledgement and end-to-end testing weeks
      • Provider resources

      Target Audience: Medical coders, physicians, physician office staff, nurses and other non-physician practitioners, provider billing staff, health records staff, vendors, educators, system maintainers, laboratories, skilled nursing facilities, home health agencies, and all Medicare providers.
      Continuing education credit may be awarded for participation in certain MLN Connects Calls. Visit the Continuing Education Credit Information web page to learn more.

      List of Valid ICD-10-CM Codes
      CMS has posted a complete list of the 2016 ICD-10-CM valid codes and code titles on the 2016 ICD-10-CM and GEMs web page. The file is named icd10cm_codes_2016.txt. This file will be useful for physician offices and other providers who want to check to make sure that they are reporting all characters in a valid ICD-10-CM code. The codes are listed in tabular order (the order found in the ICD-10-CM code book). This list should assist providers who are unsure if additional characters are needed, such as the addition of a 7th character in order to arrive at a valid code.
      A similar list of the 2016 ICD-10-PCS valid codes and code titles is available on the 2016 ICD-10 PCS and GEMs web page. The file is named icd10pcs_codes_2016.txt.

      Use of Unspecified Codes in ICD-10-CM
      CMS has a number of resources that explain unspecified codes and how they should be used in ICD-10-CM:

      • MLN Matters® Article SE1518, “Information and Resources for Submitting Correct ICD-10 Codes to Medicare”
      • ICD-10 Basics MLN Connects National Provider Call - Call Materials from August 22, 2013
      • More ICD-10 Coding Basics MLN Connects Call - Call Materials from June 4, 2014
      • ICD-10 Coding Basics MLN Connects Video - January 2014
      • Coding for ICD-10-CM: More of the Basics MLN Connects Video - December 2014

      Visit the ICD-10 Medicare Fee-For-Service Provider Resources web page for a complete list of Medicare Learning Network educational materials.

      Coding for ICD-10-CM: Continue to Report CPT/HCPCS Modifiers for Laterality
      On October 1, 2015, ICD-10-CM will replace the ICD-9-CM code set currently used by providers for reporting diagnosis codes. Implementation of ICD-10-CM will not change the reporting of Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, including CPT/HCPCS modifiers for physician services. While ICD-10-CM codes have expanded detail, including specification of laterality for some conditions, providers will continue to follow CPT and CMS guidance in reporting CPT/HCPCS modifiers for laterality.

      Transition to ICD-10 for Home Health
      Medicare requires the use of ICD-10 codes on home health (HH) claims and Requests for Anticipated Payment (RAPs) with a “Through” date on or after October 1, 2015. Since HH claims are submitted for a 60-day payment episode, there may be cases where an episode spans October 1. In these cases, the RAP for an episode will be submitted using ICD-9 codes and the corresponding claim will be submitted using ICD-10 codes. For more information, see MLN Matters Article SE1410.
      Medicare does not require ICD-10 coding of these episodes in advance of the ICD-10 implementation date. Home Health Agencies should determine whether identifying the ICD-10 codes in advance will benefit them.

      Claims that Span the ICD-10 Implementation Date
      Do you have claims that will span the ICD-10 implementation date of October 1, 2015? CMS has guidance for providers:
      • MLN Matters Special Edition Article SE1408, “Medicare FFS Claims Processing Guidance for Implementing ICD-10 – A Re-Issue of MM7492”
      • MLN Matters Special Edition Article SE1325, “Institutional Services Split Claims Billing Instructions for Medicare FFS Claims that Span the ICD-10 Implementation Date”
      • MLN Matters Special Edition Article SE1410, “Special Instructions for ICD-10 Coding on Home Health Episodes that Span October 1, 2015”

      Visit the ICD-10 Medicare Fee-For-Service Provider Resources web page for a complete list of Medicare Learning Network educational materials.

       
  3. July 27, 2015
    1. Countdown to ICD-10
      ICD-10 Is Less than 70 Days Away: Get Ready
      After several years of unparalleled cooperation across the health care community, we are nearing the ICD-10 finish line. Less than 70 days remain until our nation makes the transition to ICD-10 for coding medical diagnoses and inpatient hospital procedures on October 1, 2015. CMS is committed to helping the health care community get ready. CMS Acting Administrator Andy Slavitt recently sent a letter to all Medicare providers urging them to prepare for ICD-10.
      There is still time to get ready. To jumpstart your efforts, begin with the Quick Start Guide. Providers can also go to the Road to 10 tool to create customized action plans. Links to Road to 10 and other resources are available at cms.gov/ICD10. CMS continues to work with industry groups to support their ICD-10 progress. Many of these organizations offer free and low-cost ICD-10 resources on their websites. Vendors, health plans, and hospitals are also good sources for ICD-10 information and training.
       

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