ICD-10

Subscribe to ICD-10

On October 1, 2016, CMS is definitively ending an ICD-10 coding “flexibility” policy announced last year that prevents practitioner Medicare Part B physician fee schedule claims from being denied 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.  According to …

On August 27, 2015, CMS is hosting a call to help health care providers prepare for ICD-10 implementation on October 1, 2015. CMS staff will be joined by representatives of the American Health Information Management Association (AHIMA) and the American Hospital Association (AHA). The call will cover: the status of implementation, coding guidance; how to…

According to a recent GAO report, CMS has taken numerous steps to prepare industry for the October 1, 2015 transition to ICD-10 codes, such as developing checklists, timelines, and other educational materials and hosting training sessions for Medicare providers. CMS also has monitored covered entity and vendor readiness through stakeholder collaboration meetings, focus group…

The following Congressional panels have held hearings recently on various health policy issues:

  • The House Science, Space, and Technology Committee held a hearing entitled, “Can Americans Trust the Privacy and Security of their Information on HealthCare.gov?”;
  • The Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing on the reemergence of vaccine-preventable diseases; and

…

CMS has scheduled a series of provider calls in February and March on the following topics:

  • February 3: Special Open Door Forum on the upcoming Prior Authorization of Non-Emergent Hyperbaric Oxygen Therapy model to be implemented in March in Illinois, Michigan, and New Jersey.
  • February 4: Special Door Forum on the introduction of star ratings

…

Recent Congressional health policy hearings have addressed the following issues:

  • The Senate Health, Education, Labor, and Pensions (HELP) Committee held a hearing on generic drug pricing;
  • The House Oversight and Government Reform Committee focused on its concerns associated with transparency in passage and implementation of the Affordable Care Act in a hearing featuring CMS

…

CMS is hosting a call on November 5, 2014 to discuss implementation issues associated with the transition to ICD-10 on October 1, 2015. The call will cover the following topics: final rule and national implementation; Medicare Fee-For-Service testing; the Medicare Severity Diagnosis Related Grouper (MS-DRG) Conversion Project; partial code freeze and annual code updates; plans…

On August 6, 2014, CMS published its final rule to update Medicare payment policies under the inpatient rehabilitation facility (IRF) PPS for FY 2015. Under the final rule, CMS expects aggregate Medicare payments to IRFs will increase by $180 million, or 2.4%, compared to 2014 levels. The standard payment conversion factor for discharges for…

HHS has published a final rule that makes official the October 1, 2015 compliance date for the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) and the International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS). HHS had previously intended to transition from ICD-9 to ICD-10 on October 1, 2014, but the Protecting…

In preparation for the October 1, 2014, ICD-10 code set implementation date, CMS has posted a variety of ICD-10 checklists and planning timelines for provider practices, hospitals, and payers.  CMS also has outlined suggested steps for ensuring a smooth transition to ICD-10 and preparing for potential cash-flow disruptions from claims processing delays. For instance, CMS…

On March 5, 2013, the ICD-9-CM Coordination and Maintenance Committee is holding a public forum to discuss proposed code changes to the ICD-9-CM and ICD-10-CM/PCS code sets. As previously reported, CMS has scheduled implementation of the ICD-10-CM/ICD-10-PCS code sets for October 1, 2014. Accordingly, only limited code updates to capture new technologies and diseases will…

On October 4, 2012, CMS published technical corrections to the agency’s September 5, 2012 final administrative transactions rule that adopted a unique health plan identifier standard and delayed the implementation date for the International Classification of Diseases, 10th Revision (ICD-10) coding update from October 1, 2013 to October 1, 2014. CMS also published a rule…