CMS to reimburse for incorrect ICD-10 codes for one year
- The Centers for Medicare and Medicaid Services on Monday announced that it will reimburse for incorrectly-coded claims under the Part B physician fee schedule as long as the code is from the right family.
- The agency also announced that it will ensure coding errors don't trigging Physician Quality Reporting System, Value Based Modifier or Meaningful Use penalties; It also said it will offer advanced partial payments to providers (which must be paid back) if the change creates internal issues that slow down payment.
- The American Medical Association and CMS also announced on Monday a series of joint efforts to help physicians make the transition on October 1. The two agencies will be hosting webinars, on-site training, educational articles and national provider calls.
The partnership with CMS is a huge policy shift for the AMA, which not two months ago was advocating that the new codeset be scrapped entirely. President Steven Stack, MD suggested in an interview with Healthcare Finance that it would be best to wait until the implementation of ICD-11 and that ICD-10 should be shelved. "We believe the problems associated with ICD-10 are so substantial, our policy is we should not move forward with ICD-10," Stack said.
While CMS' new, provider-friendly policy shift probably helped tip the scale, this partnership seems indicative that the AMA—like many other critics—has accepted that the October 1 deadline is inevitable and is now ready to fulfill a support role for physicians.
- Healthcare Finance News CMS says it won't deny ICD-10 claims for a year, scores American Medical Association backing