Monday, November 17, 2014

ICD-10 Updates

 Dianne De La Mare

As reported previously, the US Department of Health and Human Services (HHS) has released a final rule setting Oct. 1, 2015, as the new compliance date for health care eproviders, health plans and health care clearinghouses to transition to ICD-10. During the upcoming MLN Connects National Provider call on Nov. 5, 2014, CMS subject matter experts discussed ICD-10 implementation issues, opportunities for testing and federal government developed resources. To see schedule for additional calls go to http://www.cms.gov/Outreach-and-Education/Outreach/FFSProvPartProg/Provider-Partnership-Email-Archive-Items/2014-10-02-eNews.html#_Toc399919412.

Further, the Centers for Medicare & Medicaid Services (CMS) has updated five ICD-10 previously released learning tools including: 1) ICD-10-CM/PCS Billing and Payment Frequently Asked Questions at http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/MLN-Publications-Items/ICN908974.html;
2) ICD-10-CM/PCS The Next Generation of Coding at http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/MLN-Publications-Items/ICN901044.html;
3) ICD-10-CM/PCS Myths and Facts at http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/MLN-Publications-Items/ICN902143.html; 4) ICD-10-CM Classificaiton Enhancements at and
4) General Equivalence Mappings Frequently Asked Questions at http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/MLN-Publications-Items/ICN903187.html; and
5)General Equivalence Mappings Frequently Asked Questions at http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/MLN-Publications-Items/ICN901743.html.

Lastly, to help providers prepare for the transition to ICD-10, CMS offers acknowledgement testing for current direct submitters (e.g., providers and clearinghouses) to test with their Medicare Administrative Contractors (MACs) and Common Electronic Data Interchange (CEDI) anytime up to the Oct. 1, 2015, implementation date. To participate in testing, go to your MAC website or through your clearinghouse. Any provider who submits claims electronically can participate in acknowledgement testing.

During the testing process, expect to: 1) test claims with ICD-10 codes and within the current dates of service; 2) test claims will receive the 277CA or 999 acknowledgement as appropriate, to confirm that the claim was accepted or rejected in the system; 3) Testing will not confirm claim payment or produce a remittance advice; and 4) MACs and CEDI will be staffed to handle increased call volume during the testing period.

 To obtain more information on acknowledgement testing and how to participate go to MLN Matters Article MM8858 at http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM8858.pdf.

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