CMS notice clarifies actions taken to address isolated ICD-10 problems

The Centers for Medicare & Medicaid Services today issued a notice clarifying actions taken since Oct. 1 to address isolated problems processing ICD-10 codes for certain national or local coverage decisions/policies. With respect to the national coverage decisions, interim solutions were implemented and a permanent systems update should be in place by Jan. 4, the agency said. In most cases, claims inappropriately rejected or denied have been automatically reprocessed and no action is required by the provider. After Oct. 1, some Medicare Administrative Contractors also needed to add allowable ICD-10 diagnosis codes for certain local coverage decisions. Affected claims with dates of service on and after Oct. 1, 2015 were generally suspended until the fixes were implemented, CMS said. Questions about specific LCDs should be directed to the appropriate MAC. As of Oct. 1, health care claims must include ICD-10 codes for medical diagnoses and inpatient hospital procedures. For more on the transition to ICD-10, visit www.aha.org and www.cms.gov.