News & Media
Are you ready for the ICD-10 Grace Period to end?
Effective October 1, 2016 claims will be required to have diagnosis codes with the highest level of specificity, making payer procedure/test requirements enforced more stringently as defined in the respective policies, such as LCD/NCD.
For example, an injection of Hyaluronan aka Hyalgan or Supartz is only covered by WPS Medicare for eight (8) diagnosis codes from the family of M17. There are eleven (11) total codes in this family. From October 1, 2015 thru September 30, 2016, any code from the M17 family would be covered for this drug. October 1, 2016 and on only the specified codes from this family will be payable. So, osteoarthritis of knee, unspecified (M17.9) most probably will result in a rejection.
With more than 1,900 ICD-10 code changes for 2017, the bar has been raised to capture a clear clinical picture through specified codes. It is important that you assess whether or not your clinical documentation is ready.
If you are looking to contract with a vendor for your data integrity and compliance needs, MSMS Practice Solutions partner, The Rybar Group, offers multiple options from which to choose and a discount for MSMS members.