CMS, AMA Work Together to Ease ICD-10 Transition, Provide Additional Flexibility

CMS has released additional guidance allowing for flexibility in claims auditing and quality reporting during the transition to the International Classification of Diseases, Tenth Revision and is working with the American Medical Association to educate providers.

CMS is working to ease the transition to the International Classification of Diseases, Tenth Revision (ICD-10). Working in conjunction with the American Medical Association (AMA), CMS has released additional guidance allowing for flexibility in claims auditing and quality reporting during the transition to ICD-10.

CMS and AMA will work together to educate providers through webinars, on-site training, educational articles, and national provider calls to help healthcare providers learn about updated codes and prepare for implementation of the new set of codes.

ICD-10 implementation is set to begin on October 1, and it is imperative that physician practices take steps beforehand to be ready,” AMA President Steven J. Stack, MD, said in a statement.

CMS has announced some changes that provide flexibility since Medicare claims processing systems will not have the capability to accept ICD-9 codes for services provided after September 30, 2015. For instance, claims will not be denied and physicians will not be subject to penalties for the Physician Quality Reporting System, the value-based modifier, or meaningful use based on specificity of diagnosis as long as the code is from the correct ICD-10 family of codes.

“The actions CMS is initiating today can help to mitigate potential problems,” Dr Stack said. “We will continue to work with the administration in the weeks and months ahead to make sure the transition is as smooth as possible.”

In addition, CMS will authorize advance payments to physicians in the event that Medicare contractors are unable to process claims resulting from problems with ICD-10 and the agency is setting up an ICD-10 communications and coordination center that will identify and resolve issues arising from transition.

“As we work to modernize our nation’s healthcare infrastructure, the coming implementation of ICD-10 will set the stage for better identification of illness and earlier warning signs of epidemics, such as Ebola or flu pandemics,” said Andy Slavitt, Acting Administrator of the Centers for Medicare and Medicaid Services.