CMS, AMA Announce Efforts to Help Providers Get Ready for ICD-10

WASHINGTON, D.C. — With fewer than three months remaining until the nation switches from ICD-9 to ICD-10 coding for medical diagnoses and inpatient hospital procedures, the Centers for Medicare & Medicaid Services (CMS) and the American Medical Assoc. (AMA) are announcing efforts to continue to help physicians get ready ahead of the Oct. 1 deadline.

In response to requests from the provider community, CMS is releasing additional guidance that will allow for flexibility in the claims-auditing and quality-reporting process as the medical community gains experience using the new ICD-10 code set.

Recognizing that healthcare providers need help with the transition, CMS and AMA are working to make sure physicians and other providers are ready ahead of the transition to ICD-10. The organizations will educate providers through webinars, on-site training, educational articles, and national provider calls to help physicians and other healthcare providers learn about the updated codes and prepare for the transition.

“As we work to modernize our nation’s healthcare infrastructure, the coming implementation of ICD-10 will set the stage for better identification of illness and earlier warning signs of epidemics, such as Ebola or flu pandemics,” said Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services. “With easy-to-use tools, a new ICD-10 ombudsman, and added flexibility in our claims-audit and quality-reporting process, CMS is committed to working with the physician community to work through this transition.”

Added AMA President Dr. Steven Stack, “ICD-10 implementation is set to begin on Oct. 1, and it is imperative that physician practices take steps beforehand to be ready. We appreciate that CMS is adopting policies to ease the transition to ICD-10 in response to physicians’ concerns that inadvertent coding errors or system glitches during the transition to ICD-10 may result in audits, claims denials, and penalties under various Medicare reporting programs. The actions CMS is initiating today can help to mitigate potential problems. We will continue to work with the administration in the weeks and months ahead to make sure the transition is as smooth as possible.”

The International Classification of Diseases, or ICD, is used to standardize codes for medical conditions and procedures. The medical codes America uses for diagnosis and billing have not been updated in more than 35 years and contain outdated, obsolete terms.

The use of ICD-10 should advance public health research and emergency response through detection of disease outbreaks and adverse drug events, as well as support innovative payment models that drive quality of care.