Early this week the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) released new FAQs and resources to address provider concerns about The International Classification of Diseases, 10th Revision (ICD-10). Starting Oct. 1, 2015, providers and hospitals will transition from the ICD-9 coding system to ICD-10. Although this change has been delayed numerous times over the past few years, 2015 appears to be the year that this transition will truly occur. For hospitals, this change means new procedure and diagnostic coding. Physicians will begin using ICD-10 for diagnostic coding on Oct. 1 but will continue to use Current Procedural Terminology (CPT) for procedure coding.
The new resources from CMS and the AMA include webinars, on-site training, educational articles and national provider calls. CMS also announced the appointment of a new ICD-10 Ombudsman to assist in triaging ICD-10 issues as they occur prior to and following the Oct. 1 transition date.
Perhaps most significantly, CMS has made a concession regarding coding accuracy in its FAQs. Question 2 indicates that, “For 12 months after ICD-10 implementation, Medicare review contractors will not deny physician or other practitioner claims billed…based solely on the specificity of the ICD-10 diagnosis code as long as the physician/practitioner used a valid code from the right family. However, a valid ICD-10 code will be required on all claims starting on October 1, 2015.” This flexibility will allow providers to become accustomed to the level of specificity required under the new coding system.
New resources can be found on the CMS website and the AMA website. For sleep-specific information, the American Academy of Sleep Medicine has created a sleep medicine crosswalk and a comorbid disorders crosswalk.