CMS names ICD-10 ombudsman

William Rogers, MD, director of the Physicians Regulatory Issues Team at the Centers for Medicare & Medicaid Services, has been named ICD-10 ombudsman.

Rogers, a practicing physician at Georgetown University Hospital, will help address concerns from healthcare professionals after the new diagnostic code library goes live on Oct. 1, according to the announcement made by acting CMS Director Andy Slavitt. He will work out of an ICD-10 coordination center in Baltimore that will be set up at the end of September, Slavitt said. Rogers can be reached at ICD10_ombudsman@cms.hhs.gov.

Rogers has been with CMS since 2003 and is a "one-stop-shop" for any issues related to the ICD-10 transition, Slavitt said. Rogers' new role will be an extension of his current job helping clinicians through other Medicare and Medicaid regulatory efforts.

Regarding the potential backlog and how that could affect reimbursement, CMS said there should be no delay in the standard turnaround time of 14 days for electronic and 29 days for paper records. CMS will not deny claims as long as the right code family is used, but the agency will not send back a message if the wrong code is used.

"While we encourage coding to correct specificity, flexibility covers the 12 months after implementation," said Chief of Staff Mandy Cohen.

CMS will not audit claims if the valid code is from the right family of codes, which is a three character category, she said. Also, Medicare will not subject physicians or other eligible professionals to the Physician Quality Reporting System, Value Based Modifier or Meaningful Use penalties, as long as the right code family is used.