Breezy Point Resort was the place to be last week with the Minnesota Medical Group Management Association Summer Conference in high gear. It is not only a time to enjoy the scenery and relax in the beautiful surroundings but also an opportunity meet with your industry colleagues and build new relationships that support your clinic.
Also on the agenda and on the horizon; the ‘ICD-10: Start, Stop, Start! Lessons Learned to Get Ready The transition to ICD-10’ session reviewed where practices need to be at for the upcoming ICD-10 transition on October 1st. A recent announcement that CMS won’t deny claims for the first year may have put some providers at ease, however the implementation, training and testing still needs to continue forward. The announcement of CMS came out of an AMA proposal pertaining to the ICD-9 code set conversion. The Centers for Medicare & Medicaid Services announced earlier in July that it would work with the American Medical Association on steps designed to ease the transition to ICD-10. The recommendations that are being implemented are as follows:
- Claims denials: CMS officials reported in a guidance document that claims won’t be denied for lack of specificity of ICD-10 coding. Quoted from the guidance document, they specifically stated that “While diagnosis coding to the correct level of specificity is the goal for all claims, for 12 months after ICD-10 implementation, Medicare review contractors will not deny physician or other practitioner claims billed under the Part B physician fee schedule through either automated medical review or complex medical record review based solely on the specificity of the ICD-10 diagnosis code as long as the physician/practitioner used a valid code from the right family.”
- Penalties and Quality reporting: CMS also explained that EPs will not be subjected to a penalty if CMS experiences difficulty calculating the quality scores for PQRS, VBM, or MU due to the transition to ICD-10 codes. CMS stated, “For all quality reporting completed for program year 2015 Medicare clinical quality data review contractors will not subject physicians or other Eligible Professionals (EP) to the Physician Quality Reporting System (PQRS), Value Based Modifier (VBM), or Meaningful Use 2 (MU) penalty during primary source verification or auditing related to the additional specificity of the ICD-10 diagnosis code, as long as the physician/EP used a code from the correct family of codes.”
- Payment: And this is a big win for AMA president Steven Stack, MD as reported on the AMA website! “If Medicare contractors are unable to process claims as a result of problems with ICD-10, CMS will authorize advance payments to physicians.” AMA president Steven Stack, MD, noted on the group’s website.
- Assistance resolving transition issues. CMS will build an ICD-10 support system , “to help receive and triage physician and provider issues.” CMS will also “identify and initiate” resolution of issues caused by the new code sets.
While the CMS announcement it made it a bit easier for MMGMA Summer Conference participants to relax on the golf course or take a sip on the boat cruise the ICD-10 transition will still take place and there is no reason to put the brakes on now. However, having CMS take a more lenient approach focused on keeping revenue flowing while the learning curve takes effect is an added cushion for practice administrators.
For practices that need direction and assistance with ICD-10 implementation and technology upgrades Outsource Receivables offers the ICD-10 Readiness materials and the complimentary assessment called the ICD-10 Stress Test. Check-out these resources and give us a call!