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CMS Provides ICD-10 Flexibility To Physicians Only

Posted on Friday, September 11, 2015 11:24 AM

After multiple requests to CMS to clarify whether home health and hospice agencies will be provided the same ICD-10 coding flexibility as permitted for physicians, NAHC has received the following response: “Thanks for your patience on this topic. CMS is not extending coding flexibility to other providers. The reason we focused on claims billed under the Part B physician fee schedule is because many physicians practice in small practices that need additional flexibility to gain experience with the ICD-10 coding set. And, claims billed under the Part B physician fee schedule are primarily paid using CPT codes and not ICD-10 codes. Other services, such as institutional services, are paid based on the ICD-10 codes. “We have named our ICD-10 Ombudsman who will listen to issues raised by all suppliers and providers and will evaluate any specific issues that are raised during implementation. CMS’s ICD-10 Coordination Center will be actively monitoring for any problems that may develop after October 1. This center will quickly identify and initiate resolution of issues that arise as a result of the transition to ICD-10.” NAHC states it's disappointed by CMS' decision to provide only physicians relief from consequences related to ICD-10 coding errors. NAHC is concerned that physicians will not have any incentive to provide agencies with information necessary to code to the level of specificity required by ICD-10 coding guidelines, and will continue to pursue CMS to provide flexibility for agencies. Click here to read more.

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