It's here! The transition to ICD-10
The transition to ICD-10 began on Thursday, October 1st. ASCO would like to hear about your succeses and struggles with the implementation. Send your questions and comments to firstname.lastname@example.org.
Updates and Reminders from the American Medical Association
The AMA has revised its online ICD-10 information and resources. If physicians experience any problems with the processing of their claims or other administrative transactions, they should take the following steps:
The AMA has created an ICD-10 complaint form available on the AMA ICD-10 web page to report problems with Medicare claims. Please note: Forms will be forwarded to the Centers for Medicare & Medicaid Services (CMS). The American Medical Association will not provide individual responses to each complaint. Physicians can also contact their Medicare Administrative Contractor (MAC) or monitor their MAC’s website for information on problems with ICD-10.
You may also contact CMS directly by emailing the ICD-10 ombudsman Dr. William Rodgers, whose contact email is ICD10_Ombudsman@cms.hhs.gov
Check the state Medicaid website for information about ICD-10 implementation and a method of contact for issues.
- Commercial Payers
Check the payer’s website for information about ICD-10 implementation and a method of contact for issues.
- For UnitedHealth Group, physicians can use the following email address ICD10questions@uhc.com
- For Humana, physicians can use the following email address ICD10Inquiries@humana.com
- For Anthem, physicians should contact the Provider Service Call Center for the locality and line of business involved (telephone numbers can be found on Anthem.com).
Any issues with practice management systems, electronic health records (EHR), billing vendors, or clearinghouses, should be directed to the company.
Physicians should also contact their state or specialty medical society (email@example.com) for advice on handling problems and to find out if other practices are experiencing similar issues.
Medicare Advanced Payment
CMS has announced that MACs will issue advanced payments in situations where the MAC is unable to process claims within established time limits because of administrative problems, such as contractor system malfunction or implementation problems. An advanced payment is a conditional partial payment and will require repayment.
To apply for an advance payment, the physician will be required to submit the request to their appropriate MAC. Should there be Medicare systems issues that interfere with claims processing, CMS and the MACs will post information on how to access advance payments. CMS does not have the authority to make advance payments in the case where a physician is unable to submit a valid claim for services rendered.
Updated Clarifying questions and answers for cms ICd-10 flexibilities
On September 22, CMS released updated “Clarifying Questions and Answers Related to the July 6, 2015 CMS/AMA Joint Announcement and Guidance Regarding ICD-10 Flexibilities.” Information added includes the naming of the CMS ICD-10 Ombudsman, Dr. William Rodgers, whose contact email is ICD10_Ombudsman@cms.hhs.gov and additional information about prior authorizations, Medicare Advantage plans, application to other provider types, Medicare advanced payments, cross-over claims, and audits.
Key Information Regarding ICD-10
ASCO staff has provided resources to get you ready for the transition. Any questions regarding ICD-10 can be sent to ASCO staff at firstname.lastname@example.org.
Introduction to ICD-10
It has been mandated that all healthcare providers in the United States comply with the International Classification of Diseases, 10th Edition, Clinical Modification/Procedure Coding System (ICD-10 CM/PCS) as of October 1, 2015.
- Why is ICD-10 being implemented?
- What are the differences between ICD-9 and ICD-10?
Read more about the basics of ICD-10.
Anatomy of an ICD-10 Code
There are significant differences in the structure of an ICD-10 CM code versus an ICD-9 CM code. Check out a few examples of the diagnoses, their corresponding ICD-10 CM code, and a description of what each digit means.
Finding an ICD-10 Code
Finding an ICD-10 Code is not much different than looking up an ICD-9 code, though you will be confronted by more choices. Read on for more information about finding the appropriate ICD-10 code.
General Equivalence Mappings (GEMS)
GEMS provide a temporary mechanism to link ICD-9 to ICD-10 and vice versa. Learn how to use GEMS to ease the transition into ICD-10.
Taking Control of the Transition to ICD-10
You don’t have to be a “victim” of ICD-10. This is a transition that can no doubt be daunting, but by planning ahead and taking the transition in pieces, it will seem less overwhelming. Several organizations offer free resources to assist with the transition.
Selecting the Appropriate ICD-10 Training Program (PDF)
Selecting the right training program for your practice is important. But how do you choose one with so many options out there. Read more.
ICD-10 from a MAC Perspective
At the July 2015 ASCO/ASH Carrier Advisory Committee meeting, Dr. Arthur Lurvey of Noridian Healthcare gave a presentation on ICD-10. The presentation highlighted topics regarding to ICD-10 as it relates to Oncology/Hematology such as: available resources, LCD/NCD changes, and coding basics. Access the 2015 CAC meeting binder and go to the presentation “ICD-10 Transition Issues.”
Disclaimer: ASCO’s ICD-10 Resources provide general information about ICD-10 issues. ASCO staff are not coding and billing consultants.