Dermatology Coding Alert

Published on Wed Dec 09, 2015 PDF

Check out these resources, too.

You’re using ICD-10, and you’re not too sure you’re doing it right. You’ve heard something about a one-year “grace period,” but what does that mean, exactly?

Not: The grace period doesn’t mean you should still be using ICD-9 for Medicare or any other payers that converted to ICD-10 on Oct. 1. But you just might get a little grace – read on to see how.

Get to the Right Family

The grace comes in the form of leniency on getting the ICD-10 code exactly right. If you get to the right “family of codes,” – which CMS recently clarified means “the ICD-10 three-character category,” you won’t get a denial for missing the most accurate code available.

For example: If your dermatologist treats a patient with varicose veins with ulcer in the right calf and you report I83 (Varicose veins of lower extremities), I83.0 (Varicose veins of lower extremities with ulcer), or I83.01 (Varicose veins of right lower extremity with ulcer), you haven’t gone far enough until you hit I83.012 (Varicose veins of right lower extremity with ulcer of calf). But Medicare will still pay for the claim during the grace period.

Resources: In addition to this ICD-10 coding “grace,” CMS is providing other ways to help ease your transition. For instance, the agency released some frequently-asked questions about ICD-10 and the grace period, which you can access at go.cms.gov/1Iq1J8Y. Plus, CMS has appointed William Rogers, MD as an ombudsman to whom you can address questions and concerns at ICD10_ombudsman@cms.hhs.gov.