Today CMS announced steps to help physicians prepare for the switch to ICD-10 coding on October 1, 2015.  Most significantly, CMS announced that during the first year after ICD-10 implementation, Medicare contractors will not deny physician or other practitioner Part B physician fee schedule claims based solely on the specificity of the ICD-10 diagnosis code, as long as the physician/practitioner uses a valid ICD-10 code from the right family.  CMS also will not subject physicians/eligible practitioners to penalties under physician quality reporting programs (Physician Quality Reporting Program, Value Based Modifier, Meaningful Use) for program year 2015 due to the additional specificity of the ICD-10 diagnosis codes as long as a code from the correct family of codes is used.  Moreover, in the event that Medicare systems issues  interfere with timely claims processing, advance payment of claims may be available.  CMS also will set up an ICD-10 coordination center with an ICD-10 Ombudsman to help resolve physician concerns during the transition.

This article is presented for informational purposes only and is not intended to constitute legal advice.