CMS Will Allow Non-specific ICD10 codes for 2015

The Centers for Medicare & Medicaid Services (CMS) announced a set of new policies related to the Oct. 1, 2015 transition to ICD-10. For the first year that ICD-10 is in place, Medicare claims will not be denied, and eligible professionals will not be penalized under PQRS, the value-based payment modifier or meaningful use based soley on the specificity of the diagnosis codes, as long as they are from the appropriate “family” of ICD-10 codes. In addition, CMS will authorize advance payments to physicians should Medicare contractors be unable to process claims as a result of ICD-10 complications. The Agency also announced plans to create a new communication center to monitor and resolve issues as quickly as possible, as well as an “ICD-10 Ombudsman” to assist providers. In a separate announcement, CMS indicated that nationally it accepted 90% of claims from more than 1,200 submitters who participated in CMS’ third round of ICD-10 “front end” (acknowledgement) testing.