ICD-10 updates start to hit coverage determinations, Medicare manual

August 5th, 2014 - Scott Kraft
Categories:   Diagnosis Coding  

By now, most physician practices have given up on dreams of another delay in the implementation of ICD-10-CM and started to take steps to train staff and engage with vendors about their readiness for the Oct. 1, 2014 changeover.

CMS and its Medicare Administrative Contractors (MACs) are taking steps of their own, and you can now start to access a lot of the newly transitioned ICD-10-CM documents for your own preparation.

First, a slew of transmittals are being released to convert, where necessary, Medicare’s Internet only policy manual to language that includes both ICD-10-CM and the conversion to the X12 5010 transaction standard from the old 4010 standard.

Remember that, for most of these changes, the policies themselves are not changing, but they are merely being updated for the ICD-10 transition.

Of even more value to any practice is the updated to local coverage determinations to reflect the ICD-10-CM codes payable for certain services. While CMS gave the MACs an April 10 deadline, many of them have already issued updated LCDs for most, if not all, of their coverage policies.

As an example, WPS Medicare, the Part B MAC for Iowa, Kansas, Missouri, Nebraska, Indiana and Michigan now lists its LCDs with side-by-side access to ICD-9 and ICD-10 versions.

One of the biggest challenges any practice is going to face in the transition – if not the biggest challenge – is getting the right diagnosis codes on the claims to help ensure they are paid with minimal delay. These LCDs will be an enormous help in your training and transition process.

Visit your own MACs site as soon as possible, and definitely no later than April 10, to download the LCDs most relevant to the services you provide at your practice so you can begin to attack how you need to update superbills and train providers, coders and billers.


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