CMS to allow more Flexibility in ICD-10 Claims Auditing

It’s crunch time for healthcare providers as the deadline for the ICD-10 transition quickly approaches and anxiety intensifies. In order to ease that anxiety, the Centers for Medicare and Medicaid Services has announced it will reimburse incorrectly-coded claims under the Part B physician fee schedule, so long as the incorrect code is from the right family. CMS also plans to establish a one-year grace period and reimburse physicians under Medicare Part B, if claims have a valid ICD-10 diagnosis code. Furthermore, CMS might authorize advanced payments to doctors if Medicare Part B contractors cannot process claims due to administrative problems.

The American Medical Association has been very clear about its desire to halt the ICD-10 transition since the problems around it are so significant. However, the AMA recently announced a series of joint efforts with CMS to help physicians make the IDC-10 transition. Both agencies will be hosting webinars, on-site training, educational articles, and national provider calls. The intentions of CMS are to help the physician community overcome the challenges of this transition. Nevertheless, it is imperative that physician practices take steps beforehand to prepare for a smooth transition and mitigate any potential problems.

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