New ICD-10 transition period: The healthcare community responds

A subject of debate for several years, the shift to ICD-10 promises great benefits along with the significant burden of increased documentation. However, critics and advocates of the code change may have reached a compromise, following a joint announcement from the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA).

CMS will take four steps to ease the ICD-10 transition for providers for a period of one year, including:

  • Not denying claims based solely on code specificity; as long as a code is selected from the appropriate code family, it will not be denied
  • Not subjecting physicians to penalties for the Physician Quality Reporting System (PQRS), the value-based payment modifier or meaningful use, as long as they use an ICD-10 code from the correct family of codes
  • Authorizing advance payments to physicians if Medicare contractors cannot process claims as a result of problems with ICD-10
  • Creating a communication center and appointing an ICD-10 ombudsman to address ICD-10 issues

Does this grace period truly meet the needs of both sides of the ICD-10 debate? Several healthcare organizations and experts spoke out following the announcement — read their opinions below.

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AMA, American Association of Orthopaedic Surgeons, American Medical Association, Centers for Medicare & Medicaid Services, CMS, DST Health Solutions, ICD-10, Medicare, Physician Quality Reporting System, PQRS, value-based payment


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