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Countdown to ICD-10 Implementation

September 2015, Vol 5, No 6

The sound that is getting impossible to ignore is the clock ticking down to the implementation of the International Classification of Diseases, Tenth Edition (ICD-10) at 12:01 am on Thursday, October 1, 2015. All healthcare stakeholders are hearkening to the countdown and making sure that people are not squeezed out of the practice of medicine by insufficient time and support to comply with ICD-10.

The American Society of Clinical Oncology (ASCO) and the American Society of Hematology (ASH) are working to help physicians have the information they need. During the July 2015 meeting of the ASCO/ASH Carrier Advisory Committee meeting, Arthur Lurvey, MD, FACP, of Noridian Healthcare Solution, discussed topics related to ICD-10. He highlighted topics related to ICD-10 in the context of oncologists and hematologists, including available resources for the transition and the basics of ICD-10 coding.

Coding Issues

The Centers for Medicare & Medicaid Services (CMS) and the American Medical Association have granted a 1-year grace period. Medicare Part B claims will not be denied up to September 30, 2016, if there is a lack of specificity of the ICD-10 diagnosis codes, as long as the code is from the correct family of codes (www.cms.gov/Medicare/Coding/ICD10/Downloads/MedicareProviderICD-10.pdf).

A similar policy will be followed by Medicare administrative contractors and recovery audit contractors. In addition, clinicians and practices will not be subjected to penalties in the Physician Quality Reporting System, the Value-Based Payment Modifier program, or the Meaningful Use program relating to the specificity of ICD-10 codes during primary-source verification or auditing.

CMS staff will also not penalize practices if the staff encounters difficulties calculating quality scores for ICD-10 codes, as long as the codes are from the appropriate families.

In another helpful move, CMS is creating the position of an ICD-10 ombudsman to resolve problems during the transition. The organization also will authorize advanced payments if Medicare contractors cannot process claims within the established time limits as a result of problems with ICD-10 implementation. There are also listings of common codes for several specialties.

Information on the 1-year grace period provided by CMS is also outlined by ASCO on “ASCO in Action,” the policy news section of ASCO’s website (www.asco.org/practice-research/ICD-10).

CMS also created a section dedicated to ICD-10 implementation (www.roadto10.org), which is designed to help small physician oncology practices start using ICD-10 on time. The website features webcasts on topics ranging from “Training and Preparation on the ‘Road to 10’” to “Clinical Documentation and Coding on the ‘Road to 10.’”

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