In early July, CMS and the AMA came together for a joint news release. In this release, CMS indicated it would not deny Part B claims from physicians or other practitioners based solely on the specificity of the ICD-10 diagnosis code as long as it is from the right “family.” This reprieve is set to last for 1 year, although there was no real explanation of what is meant by family. CMS also pledged to create an office and official to prioritize and evaluate questions about the submissions of claims. The October 1 deadline was held firm and there was no reprieve to allow for submission of claims from both ICD-9 and ICD-10 code sets. APS views this as good news, as it should allow for better understanding of NCD, LCD, CCI and other diagnosis related payment edits implemented by CMS and adopted by commercial carriers. We remain ICD-10 ready and will continue to keep you updated as we approach implementation.
In working through the wide variety of billing arrangements, APS found payments that we had been missing.