ICD CMS Announces Grace Period for ICD-10 Mistakes

[Laureen]

From Medscape...

In a significant concession to organized medicine, the Medicare program yesterday announced a 1-year grace period for claims bearing the fastidious ICD-10 diagnostic codes that go into effect October 1.

Here's the grace: Claims won't be rejected for payment simply because the ICD-10 code submitted isn't specific enough. [read more...]

This should ease the pain. At least they don't seem to be trying to delay it.

 

[Alicia Scott]

I think this is huge everyone. Looks like we are in it this time. No more delay I suspect.

 

[AliciaL1]

I had a Practicode radiology report I coded. I ended up coding a more specific code. I was marked wrong. Indications stated left leg pain. Well, the images taken were of the TIB/FIB. So I coded left LOWER leg pain.

I ended up sending in a query for feedback. Maybe I am wrong with what I had coded, but I questioned it anyways! I felt there was a more specific code. We'll see.

I'm a newbie. I learned the ICD 10 in school, then did the ICD 9 fastrack. I was just starting to get the hang of ICD 9! LOL
I get stumped a lot of time on the ICD 10 codes for the spine conditions; spondylosis, degenerative changes, displacement, etc. Ugh! Those get so frustrating for the ICD 10! However every time I get one wrong, I'm usually making notes in my book, that's for sure

 

[Alicia Scott]

You are correct and it was a good idea to let them know. Good catch. Spines are a doozy for anyone. It is a excellent to get that practice in. I struggle with Spines and have to double check myself.

 

[Stephanie7480]

I got this info from my AAPC chapter meet in Cbus,OH last week (Thank you Juan Lumpkin of CGS) but didn't see anything published to share till now.

"The ICD-10 flexibility policy applies only to post-payment reviews, not to prepayment reviews, prior authorization, or initial claims adjudication."

"The bottom line is that after October 1, it will still be crucial to assign codes that are not only valid but also specific. Use of nonspecific codes may result in claim denials and loss of payment."
http://www.codingstrategies.com/news
http://www.codingstrategies.com/news

Stephanie W. CPC

 

[Laureen]

Thanks for sharing that Stephanie!