The Advocacy Council of the ACAAI wants to make you aware of some important developments with respect to the transition to ICD-10, that were brought to our attention this morning by the AMA's new Speaker of the House (and College member since 1985) Susan R. Bailey, MD. The AMA and CMS today issued a joint press release reporting agreement on certain elements of a 12-month "grace period" for the October 1, 2015 implementation of ICD-10. Although physicians must still begin using ICD-10 on October 1, 2015, there will be leniency with respect to failure to code to the correct specificity. As explained in a Q and A that accompanied the press release
- Medicare Administrative Contractors and RACs will not audit or deny claims based solely on the specificity of the ICD-10 code for 12-months after implementation provided the physician submitted an ICD-10 code from the appropriate family of codes.
- Physicians will not be penalized with respect to their quality scores in PQRS, VBM and Meaningful Use during Program Year 2015 if CMS experiences difficulty in accurately calculating these scores because of the change to ICD-10.
- CMS will establish an ICD-10 Ombudsman to address physician problems during the transition.
- MS will authorize advanced payments if Medicare contractors are unable to process claims within established time frames because of problems with ICD-10 implementation.
For more information on preparing for ICD-10 please see: https://education.acaai.org/content/icd-10-resources