July 10, 2015 - The Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) announced efforts to help physicians prepare for the nationwide switch from ICD-9 to ICD-10 ahead of the October 1 deadline. In response to requests from the provider community, CMS is releasing additional guidance that will allow for flexibility in the claims auditing and quality reporting process as the medical community gains experience using the new ICD-10 code set for medical diagnoses and inpatient hospital procedures.
Reaching out to healthcare providers all across the country, CMS and AMA will in parallel be educating providers through webinars, on-site training, educational articles and national provider calls to help physicians and other healthcare providers learn about the updated codes and prepare for the transition.
The International Classification of Diseases, or ICD, is used to standardize codes for medical conditions and procedures. The medical codes America uses for diagnosis and billing have not been updated in more than 35 years and contain outdated, obsolete terms.
The use of ICD-10 should advance public health research and emergency response through detection of disease outbreaks and adverse drug events, as well as support innovative payment models that drive quality of care.
CMS' free help includes the "Road to 10" aimed specifically at smaller physician practices. The program features primers for clinical documentation, clinical scenarios and other specialty-specific resources to help with implementation. CMS has also released provider training videos that offer helpful ICD-10 implementation tips. The AMA also has a broad range of materials available to help physicians prepare for the October 1 deadline.
CMS also detailed its operating plans for the ICD-10 implementation. Upcoming milestones include:
- Setting up an ICD-10 communications and coordination center, learning from best practices of other large technology implementations that will be in place to identify and resolve issues arising from the ICD-10 transition;
- Sending a letter in July to all Medicare fee-for-service providers encouraging ICD-10 readiness and notifying them of these flexibilities;
- Completing the final window of Medicare end-to-end testing for providers this July;
- Offering ongoing Medicare acknowledgement testing for providers through September 30;
- Providing additional in-person training through the "Road to 10" for small physician practices; and
- Hosting an MLN Connects National Provider Call on August 27.
In accordance with the coming transition, the Medicare claims processing systems will not have the capability to accept ICD-9 codes for dates of services after Sept. 30, 2015, nor will they be able to accept claims for both ICD-9 and ICD-10 codes.
Also, at the request of the AMA, CMS will name a CMS ICD-10 Ombudsman to triage and answer questions about the submission of claims. The ICD-10 Ombudsman will be located at CMS's ICD-10 Coordination Center.