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CMS and AMA Team Up to Ease ICD-10 Transition: Healthcare

Just 86 days before ICD-10 coding will become the national standard, the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) announced their combined efforts to assist health care providers in observing the looming deadline. On Monday, July 6, 2015, CMS issued a press release promoting the collaborative efforts of both organizations to provide webinars, on-site training, educational articles, and other services to prepare health care providers across the nation for the transition away from ICD-9.

According to the Acting Administrator of CMS Andy Slavitt, the impending implementation of ICD-10 will “modernize our nation’s health care infrastructure”, by improving the identification of illness and epidemics, as well as the claims audit and quality reporting processes.

AMA President Steven J. Stack, M.D. praised CMS’s collaboration as a positive response to physician concerns about the upcoming compliance date.

The top question on the minds of many providers is: will my claim be denied if I use the wrong ICD-10 code?

According to the FAQ recently released by CMS: For the first 12 months of ICD 10, as long as the provider uses a valid ICD-10 code from the correct family, Medicare will not deny claims.

You can read more at the following links:

Centers for Medicare and Medicaid Services: Frequently Asked Questions

Centers for Medicare and Medicaid Services: Provider Resources

American Medical Association: ICD-10 Code Set to Replace ICD-9

CMS also stated its intention to establish an ICD-10 communication and coordination center to identify and resolve issues as they emerge throughout the transition.

All providers are encouraged to prepare for the upcoming transition to ICD-10. Medicare claims with dates of service after October 1, 2015 will not be accepted in ICD-9 format.

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About this Author

Stacey A. Borowicz, Regulatory, Health care industry, attorney, Dinsmore Shohl,
Associate

Stacey Borowicz is an accomplished attorney who dedicates the majority of her business and regulatory practice to health care providers. Stacey brings with her more than a decade of front line experience in the health care industry as she acquired a rare set of skills as a medical researcher/scientist prior to entering the practice of law.

Stacey's experience in the healthcare representation is diverse and includes Medicare/Medicaid audit and overpayment appeals, voluntary disclosures and refunds. Stacey also brings a wealth of experience in...

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Brendan T. O'Reilly, Dinsmore, Corporate Health Care Attorney, HIPAA Lawyer
Associate

Brendan is a member of the Corporate Department, focusing his practice on health care law. His experience is wide-ranging, including counseling health care providers through administrative hearings and appeals, as well as addressing state licensure revocation proceedings and professional disciplinary actions. He also has handled Certificate of Need applications and appeals, HIPAA breach notices and disclosure, and an array of general employment and transactional agreements. Brendan’s experience also includes some general corporate work, including working with clients to manage estate planning, franchise law and business entity formation matters.

Prior to joining Dinsmore, he served as a judicial extern to Chief Justice Maureen O’Connor with The Supreme Court of Ohio, as well as to the Hon. Jack Zouhary with the U.S. District Court for the Northern District of Ohio. Brendan also previously worked for the Ohio Innocence Project, where his efforts earned him the Lois Rosenthal Award for skill, determination and passion for justice.     

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