According to CMS’ first reported metrics, CMS has received 4.6 million Medicare fee-for-service claims per day since the commencement of ICD-10 on October 1, 2015. The results? CMS deemed the transition a successful one. The fact that we have not seen a flood of denials is due primarily to CMS observing a 12-month grace period – not denying claims for lack of specificity during this period.
What we know is that better documentation equals better information which equals more specificity to the coding guidelines related to ICD-10.
Now that we have made the transition and are 6 months into ICD-10, we are looking for trends and potential issues for our clients. This trending will help us as we move closer to the second year and first set of updates to ICD-10 code set. This will also be beneficial to ebix and our clients as we draw closer to the discontinuation of the grace period from Medicare and we enter year two of ICD-10.
Keep in mind that ICD-10 updates take place annually on October 1, following the same timeline used for ICD-9 updates. Be sure to keep your systems and coding tools up to date and review the general coding guidelines on a regular basis. Also make sure that you are doing everything that you can in order to not use “unspecified” ICD-10 codes. Unspecified codes should see an increase in denials as we move into year two of the transition.
More on the ICD-10 timeline can be accessed here.