Tuesday, August 18, 2015

ICD-10 Update

Dianne De La Mare

The Centers for Medicare & Medicaid Services (CMS) has recently redesigned its Medicare Fee-For-Service Provider Resources page, with updated information on ICD-10. Take a look to learn more about: Claims processing and billing guidance, Coding, Unspecified ICD-10-CM codes, General Equivalence Mappings (GEMs), Home health provider information, National Coverage Determinations (NCDs), Local Coverage Determinations (LCDs), Testing and results and Features and benefits. Additionally, the page indicates 5 ways that Medicare providers can check their claims status after the implementation of ICD-10 including:

· Interactive Voice Response (IVR): IVR gives providers access to Medicare claims information through a toll-free telephone number. Visit your Medicare Administrative Contractor (MAC) website for information on the Provider Contact Center and IVR user guide.

· Customer Service Representative (CSR): Visit your MAC website for information on the Provider Contact Center only if you are unable to access claims information via IVR.

· MAC portal: Visit your MAC website for portal features and access.

· Direct Data Entry (DDE): Providers that bill institutional claims are also permitted to submit claims electronically via DDE screens. Visit your MAC website for more information.

 · ASC X12: The ASC X12 Health Care Claim Status Request and Response (276/277) is a pair of electronic transactions you can use to request the status of claims (via the 276) and receive a response (via the 277). Visit your MAC website for more information.


Lastly, CMS has released a new infographic with facts about ICD-10 coding, reimbursement, testing, and resources. Visit the CMS ICD-10 website and Roadto10.org for the latest news and resources to help you prepare. 

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