AMA working with CMS to ready providers for ICD-10

The American Medical Association (AMA) has finally shifted from fighting the ICD-10 implementation to efforts to help physicians be ready in time for the Oct. 1 deadline.

The Centers for Medicare & Medicaid Services (CMS) is releasing additional guidance that will allow for flexibility in the claims auditing and quality reporting process as the medical community gains experience using the new ICD- 10 codeset.

AMA wants to make sure providers are ready for ICD-10 and will work with CMS to provide education through webinars, on-site training, educational articles and national provider calls to help physicians and other healthcare providers learn about the updated codes and prepare for the transition.

“As we work to modernize our nation’s healthcare infrastructure, the coming implementation of ICD-10 will set the stage for better identification of illness and earlier warning signs of epidemics, such as Ebola or flu pandemics.” said Andy Slavitt, acting administrator of CMS. “With easy to use tools, a new ICD-10 Ombudsman, and added flexibility in our claims audit and quality reporting process, CMS is committed to working with the physician community to work through this transition.” 

“ICD 10 implementation is set to begin on October 1, and it is imperative that physician practices take steps beforehand to be ready,” said AMA President Steven J. Stack, MD. “We appreciate that CMS is adopting policies to ease the transition to ICD-10 in response to physicians’ concerns that inadvertent coding errors or system glitches during the transition to ICD-10 may result in audits, claims denials, and penalties under various Medicare reporting programs. The actions CMS is initiating today can help to mitigate potential problems. We will continue to work with the administration in the weeks and months ahead to make sure the transition is as smooth as possible.” 

CMS also shared the following upcoming milestones related to ICD-10 implementation: 

• Setting up an ICD-10 communications and coordination center, learning from best practices of other large technology implementations that will be in place to identify and resolve issues arising from the ICD-10 transition.
• Sending a letter in July to all Medicare fee-for-service providers encouraging ICD-10 readiness and notifying them of these flexibilities.
• Completing the final window of Medicare end-to-end testing for providers this July.
• Offering ongoing Medicare acknowledgement testing for providers through September 30th.
• Providing additional in-person training through the “Road to 10” for small physician practices.
• Hosting an MLN Connects National Provider Call on August 27th.

In accordance with the coming transition, the Medicare claims processing systems will not have the capability to accept ICD-9 codes for dates of services after Sept. 30, nor will they be able to accept claims for both ICD-9 and ICD-10 codes.

Also, at the request of the AMA, CMS will name a CMS ICD-10 Ombudsman to triage and answer questions about the submission of claims. The ICD-10 Ombudsman will be located at CMS’s ICD-10 Coordination Center.