ICD-10 Transition Specificity Eased

In a joint statement Monday, the American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS) bent to industry pressure and finally announced new guidance to help ease providers into the transition from ICD-9 to ICD-10. The announcement, expected by ADVOCATE, has two significant areas of impact for radiology providers.

The biggest impact of the announcement was that for 12 months after ICD-10 implementation, Medicare will not deny radiology claims based solely on the specificity of the ICD-10 diagnosis code as long as the claim is submitted using a valid ICD-10 code from the right family. This change will alleviate the majority of claims at risk for denial due to ICD-10.  Keep in mind however, that a valid ICD-10 claim could be denied for reasons other than the specificity of the ICD-10 code.


Second, advance payment will be available from Medicare if Medicare is unable to process claims within established time limits because of administrative problems. With the announcement Monday, Medicare system issues could now be the highest risk factor in the transition.  ADVOCATE is working with Medicare intermediaries nationally to document the advance funds request process to be prepared if the need arises for our clients.

ADVOCATE just finished a series of 3 free webinars on ICD-10 transition & preparation for radiology practices.  If you missed one of them, no worries!  Please click here to access a free recording of the webinar.

As always, ADVOCATE will keep you up to date on this and all issues impacting radiology as they become available.

Best regards,
Kirk Reinitz, CPA