ICD-10 Changes and Medicare Revalidation

Reminder! ICD-10 changes effective Oct. 1

The one-year anniversary of ICD-10 is approaching and with it comes some important changes. 

  • When ICD-10 became effective in 2015, CMS required clinicians use the most specific code available. CMS stated they would not audit a practice for lack of specificity until after Oct. 1, 2016. Unspecified codes may still be used when needed, but it is important to use as much specificity as possible – which may be helpful in other payment systems moving forward.

For more coding information, the College offers a host of ICD-10 resources in our ICD-10 toolkit.

Are you due for Medicare enrollment revalidation? 

CMS has begun its second round of Medicare enrollment revalidations, during which providers will be required to revalidate their entire Medicare enrollment record. The revalidation schedule varies, and Medicare will send a notice two to three months prior to your due date either by email or regular mail. You can check your revalidation due date online. Providers due for revalidation within six months will display a revalidation due date, and all others will display a “TBD.” We strongly recommend you check this website regularly to see if you are due for revalidation, since Medicare may send your notice to an incorrect email or mailing address.

The fastest and most efficient way to submit your revalidation information is by using PECOS. To review CMS’ validation requirements and the revalidation process, view this CMS Resource.

CMS can deactivate your billing privileges for failure to complete a revalidation application by the due date. Deactivated providers will be required to submit a new full and complete application in order to reestablish their provider enrollment record and related Medicare billing privileges.

Advocacy Issue: 
Billing, Coding & Payments