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CMS, AMA announce plans to help providers through ICD-10 conversion

After formerly questioning how the Centers for Medicare and Medicaid Services is handling the upcoming ICD-10 conversion, the American Medical Association (AMA) announced it will work with CMS on programs and educational sessions to assist providers in switching over to ICD-10.

The two groups will conduct onsite training, webinars, and national provider calls and publish educational articles to teach providers about the ICD-10 code set, according to CMS and the AMA.

“We appreciate that CMS is adopting policies to ease the transition to ICD-10 in response to physicians’ concerns that inadvertent coding errors or system glitches during the transition to ICD-10 may result in audits, claims denials, and penalties,” said AMA President Steven J. Stack, M.D.

That statement contrasted with a letter addressed to CMS by the AMA earlier this year, in which the AMA and 99 other groups expressed worry that not enough was being done to avoid anticipated breakdowns that could result in billions of dollars in lost productivity during the ICD-10 conversion. The AMA used an ICD-10 testing session — in which nearly one in five claims was rejected — as evidence that not all healthcare providers and coders were inclined to make a smooth passage from ICD-9 to ICD-10.

Part of CMS’ ICD-10 guidance is its website, Roadto10.org. It is an ICD-10 transition guide designed for small physician practices. CMS also plans to appoint a CMS ICD-10 ombudsman to respond to questions about claims submissions. A few of CMS’ other methods of aiding the ICD-10 conversion are:

  • Establishing an ICD-10 communications and coordination center
  • Performing another round of Medicare end-to-end testing for providers this month
  • Sending a letter to Medicare fee-for-service providers apprising them of CMS’ plans to help them with ICD-10 preparedness
  • Offering in-person instruction — through the “Road to 10” initiative — for smaller physician practices

Andy Slavitt, acting CMS administrator, commented on the group’s constructive intentions in the AMA release. He said, “With easy-to-use tools, a new ICD-10 ombudsman, and added flexibility in our claims audit and quality reporting process, CMS is committed to working with the physician community to work through this transition.”

During the first year after ICD-10 implementation a physician claim will not be denied for a lack of specificity, as long as the physician uses a valid ICD-10 code from the right code family, according to a CMS resource.

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