Physician Resource: ICD-10

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The ICD-10 Grace Period Ends Oct. 1, 2016

The one-year grace period for ICD-10 will end on Oct. 1, 2016, the Centers for Medicare and Medicaid Services announced in an update to its FAQ guidelines for the diagnostic code set.

ICD-10 went live on Oct. 1, 2015, and at the time CMS said it would not deny claims as long as physicians used codes in the correct “family” related to the treatment. However, with the grace period ending, physicians will now be held to using the correct degree of specificity in their coded claims.

“ICD-10 flexibilities were solely for the purpose of contractors performing medical review so that they would not deny claims solely for the specificity of the ICD-10 code as long as there is no evidence of fraud,” CMS said.

ICD-10, which contains more than 70,000 diagnostic codes, replaced ICD-9, which relied on just 11,000 codes. The grace period had only applied to claims submitted to Medicare and Medicaid, and while many commercial insurers offered similar flexibility, the majority did not.

RESOURCES FOR PHYSICIANS

Visit Road to 10: The Small Physician Practice’s Route to ICD-10 for a variety of webinars, videos, FAQs and infographics for detailed information to help you during the transition.

ICD10Watch

American Academy of Family Practitioners’ Free ICD-10 Assessment and Maintenance Toolkit

American Medical Association’s ICD-10 Educational Resources and Implementation Tools

Centers for Disease Control and Prevention National Center for Health Statistics ICD-10 Transition Resources

Centers for Medicare & Medicaid Services ICD-10 Resources

Clarifying Questions and Answers Related to the July 6, 2015, CMS/AMA Joint Announcement and Guidance Regarding ICD-10 Flexibilities (PDF)

ARTICLES

ICD-10 Grace Period Ends Oct. 1 (Revised September 9, 2016)

What You’re Saying about ICD-10, One Month Later (Revised November 2, 2015)

ICD-10 Is Here…Now What? (Revised October 8, 2015)

What You Said…about ICD-10 (Revised October 1, 2015)

ICD-10: “This should be a wake-up call … to be an advocate” (Revised October 1, 2015)

Problems with ICD-10 Implementation? Check Out These Tips… (Revised September 30, 2015)

Last Minute ICD-10 Items (Revised September 25, 2015)

ICD-10: 26 Tips You Absolutely Want to Know! (Revised September 23, 2015)

Four ICD-10 Myths from a Critical Doc (Revised September 23, 2015)

ICD-10 Conversion Services: Pre- and Post-Transition Support

Resources to Help You Prepare for ICD-10 – FAQs (Revised September 17, 2015)

Alabama Medicaid to Honor Physician ICD-10 ‘Grace Period’ for Coding Errors (Revised September 10, 2015)

ICD-10 FAQ List Revised to Clarify Billable Code (Revised August 19, 2015)

Physicians Not Ready for ICD-10, New Survey Says (Revised August 14, 2015)

More Q&As Regarding ICD-10 Guidance and Flexibilities (Revised July 31, 2015)

ICD-10: 75 Days and Counting (Revised July 6, 2015)

Association Supports Rep. Palmer’s ICD-10 “Grace Period” Bill (Revised June 19, 2015)

American Medical Association ICD-10 Implementation House of Delegates Resolution 211, Introduced by Alabama Delegation

Written Testimony for Jeff Terry, M.D.: House Committee on Ways and Means Hearing, “Obamacare Implementation and the Department of Health and Human Services FY16 Budget Request”  (June 10, 2015)

State Lawmakers Urge Congress to Delay ICD-10 (Revised June 5, 2015)

Act 2015-279: SJR 79 by Sen. Tim Melson, M.D., Urging Congress to take all necessary measures to delay the mandated implementation of ICD-10 and lessen the burden on Alabama’s medical practices (May 26, 2015)

ICD-10 Switch Will Cause Problems in the ER (Revised May 29, 2015)

Bill in U.S. House Would #StopICD10 (Revised May 8, 2015)

Flawed Implementation of ICD-10 Less than Six Months Away (Revised April 16, 2015)

Alabama Physician Lone ICD-10 Dissenter During Congressional Hearing (Revised Feb. 16, 2015)

Headache for Doctors; Heartache for Patients (Revised Jan. 12, 2015)

Letter to the Editor: Ever Been Bitten by a Killer Whale? (Revised Oct. 1, 2014)