Medicare ICD-10 Testing
Oct. 1, 2015 is the current deadline for the implementation of the International Classification of Diseases 10th Edition (ICD-10). The transition to ICD-10 is required for everyone covered by the Health Insurance Portability Accountability Act (HIPAA), and will be the coding standard for submitting claims to both Medicare and Medicaid.
The Centers for Medicare and Medicaid Services (CMS) web resource for ICD-10 is available by clicking here.
The New York Medicaid (eMedNY) web resource is available by clicking here.
Providers should be routinely checking both these websites for resources and the latest updates on ICD-10 implementation.
The Centers for Medicare and Medicaid Services (CMS) has issued recent guidance on the implementation process and for end-to-end testing for providers. Please note the following:
- Medlearn Matters article SE1435 - Frequently Asked Questions - International Classification of Diseases, 10th Edition (ICD-10) End-to-End Testing
- Medlearn Matters article SE1325 - Institutional Services Split Claims Billing Instructions for Medicare Fee-For-Service (FFS) Claims that Span the ICD-10 Implementation Date
- Medlearn Matters article SE1409 - Medicare FFS ICD-10 Testing Approach
For a comprehensive listing of all the CMS guidance documents and resources on ICD-10 please click here.
Providers should be developing an implementation strategy that includes an assessment of the impact on your organization, a detailed timeline and budget. In addition, providers should be conferring with their billing service, clearinghouse or software vendor to confirm their compliance readiness.
For providers that anticipate not being able to complete the necessary systems changes to submit claims with ICD-10 codes by Oct. 1, 2015, providers should investigate downloading the free billing software that CMS offers via their Medicare Administrative Contractor (MAC) websites. For New York the MAC is National Government Services. The software has been updated to support ICD-10 codes and requires an internet connection. This billing software only works for submitting FFS claims to Medicare.
Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827