New guidance from the Centers for Medicare and Medicaid Services about ICD-10-CM coding

A recent set of questions and answers is part of an expanded effort to help providers prepare for the change in diagnostic code usage.

With the Oct. 1, 2015, deadline looming for the switch from ICD-9-CM to ICD-10-CM diagnostic coding, the Centers for Medicare and Medicaid Services (CMS) published guidance earlier this month about the impending change.

Among the highlights:

  • Medicare claims for services provided on or after Oct. 1 must use ICD-10-CM diagnostic codes; claims with ICD-9-CM codes will be rejected. However, Medicare contractors will not deny claims based solely on the specificity of the ICD-10-CM code chosen. The claim must contain a valid ICD-10-CM code from the “right family” of codes related to the service provided.
  • CMS is setting up a “communications and collaboration center” for monitoring and resolving issues that arise during the switch to ICD-10. As the Oct. 1 compliance date nears, the agency will inform providers about how to submit issues to a designated “ICD-10 ombudsman.” 

As part of its recent guidance, CMS published a set of questions and answers (PDF, 199KB) about getting ready for ICD-10. 

Additional guidance for APA Practice Organization members is available in the “Are You Ready for ICD-10-CM? (PDF, 371KB)” article in the Spring/Summer 2015 issue of Good Practice magazine.