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August 30, 2016



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AAOS Thanks Ryan for 21st Century Cures Support

ICD-10 Grace Period Ending

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ICD-10 Grace Period Ending

The Centers for Medicare & Medicaid Services (CMS) recently updated a FAQ on requirements related to the ICD-10 transition, reminding physicians that the flexibility program, announced July 2015, is ending October 1.

CMS announced the flexibility program last year after pressure from AAOS and other organizations. The flexibility period ensured that doctors would not be penalized with claims denials or quality-reporting penalties as long as they select a diagnosis code from the right family of codes for the first year of implementation.

“CMS will not extend ICD-10 flexibilities beyond October 1, 2016. There will be no additional flexibility guidance. As of October 1, 2016, providers will be required to code to accurately reflect the clinical documentation in as much specificity as possible,” the FAQ update states, noting that many insurers are already imposing such requirements. “Providers should already be coding to the highest level of specificity. 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. These ICD-10 medical review flexibilities will end on October 1, 2016. As of October 1, 2016, providers will be required to code to accurately reflect the clinical documentation in as much specificity as possible, as per the required coding guidelines.”

CMS also recently promoted the agency’s ICD-10 Assessment and Maintenance Toolkit, which they say can help you maintain your ICD-10 progress. According to CMS, “this in-depth toolkit shows how you can manage your revenue cycle by: assessing ICD-10 progress using key performance indicators (KPIs) to identify potential productivity or cash flow issues; addressing opportunities for improvement; and maintaining progress and keeping up-to-date on ICD-10.” The toolkit is also available as an infographic with an accompanying fact sheet on KPIs to help you analyze and track your ICD-10 progress.

Visit the CMS ICD-10 website for the latest news and official resources, including the ICD-10 Quick Start Guide and a contact list for provider Medicare and Medicaid questions. You can also sign up for CMS ICD-10 Email Updates and follow CMS on Twitter.

Read more about AAOS ICD-10 efforts: