With just one month to go before the Oct. 1 implementation deadline for ICD-10, the Centers for Medicare & Medicaid Services (CMS) is working to provide additional clarity and assistance for physicians.
“As with everything, this transition can be highly successful,” said CMS Acting Administrator Andy Slavitt on a call for physicians and other health care professionals Thursday. “There will be bumps and challenges—our job is to plan for them, too.”
In July, CMS announced that the AMA secured flexibilities for physicians to make the transition to ICD-10 less disruptive. Mainly, physicians should be aware that for the first year ICD-10 is in place, Medicare Part B claims will generally not be denied solely based on the specificity of the diagnosis codes as long as they are from the appropriate family of ICD-10 codes. Get the full list of what physicians need to know about these flexibilities at AMA Wire®.
Part of the provisions the AMA secured include CMS establishing a communication center to monitor issues and an ICD-10 ombudsman devoted to triaging physician issues. Slavitt said the communication center, headquartered in Baltimore, will begin operation at the end of September. He also announced that William Rogers, MD, an emergency physician who heads CMS’ Physician Regulatory Issues Team, will be the ombudsman.
Dr. Rogers’ “role as ombudsmen will be to be a one-stop shop for you with questions and concerns,” Slavitt said. Dr. Rogers also will “be your internal advocate in CMS.”
Physicians can contact Dr. Rogers via email at [email protected].
Agency releases final round of testing results
About 1,200 physicians and other health care professionals participated in CMS’ final end-to-end testing week in late July. The acceptance rate for July was similar to rates in the previous two testing weeks.
According to CMS, here are the final end-to-end testing numbers:
- 29,286 test claims received
- 25,646 test claims accepted
- 87 percent acceptance rate
- 1.8 percent of test claims were rejected as a result of an invalid submission of ICD-10 diagnosis or procedure code
- 2.6 percent of test claims were rejected as a result of an invalid submission of ICD-9 diagnosis or procedure code
“In some cases, testers may have intentionally included errors in their claims to make sure that the claim would be rejected,” the agency said.
Additional rejections were from non-ICD-10-related errors, including incorrect National Provider Identifiers, health insurance claim numbers or submitter IDs. Other errors included dates of service outside the range valid for testing and invalid place of service.
“Most rejects were the result of provider submission errors in the testing environment that would not occur when actual claims are submitted for processing,” the agency said.
The results indicate that “no new ICD-10-related issues were identified in any of the Medicare fee-for-service claims processing systems,” officials said.
Still time to prepare
Though the clock is ticking down, you still have time to get your practice prepared. Important resources that can help you get ready over the next few weeks include:
- A free online module in the AMA’s STEPS Forward collection that offers materials to help you prepare.
- The AMA’s ICD-10 Web page offers important information and resources on implementation planning, from cross-walking between ICD-9 and ICD-10 to testing your readiness.
- CMS also is offering free assistance, including its “Road to 10” website aimed specifically at smaller physician practices. This collection includes primers for clinical documentation, clinical scenarios and other specialty-specific resources to help with implementation. Read more about the agency’s resource offerings.
