Pain Management Coding Alert

Published on Wed Dec 02, 2015 PDF

Question: We’re trying to implement ICD-10 correctly and include the proper diagnosis codes on our claims. We don’t know how well we’re actually doing, however, because we’ve not received any claims containing ICD-10 codes from our insurers yet. Has there been any news on how the ICD-10 system is working so far?

Minnesota Subscriber

Answer: According to Medicare, ICD-10 is already a smashing success.

Though ICD-10 has only been in play for about two months, the Centers for Medicare & Medicaid Services (CMS) is starting to praise it. The agency recently released some stats about the new diagnosis coding system, and those numbers are quite positive.

Between Oct. 1 and Oct. 27, Medicare processed 4.6 million ICD-10 claims per day, and only 10.1 percent of them were denied. Out of the denials, 0.1 percent were rejected due to an invalid ICD-10 code, and another 2 percent were denied because of incomplete or invalid information.

“CMS has been carefully monitoring the transition and is pleased to report that claims are processing normally,” the agency said in the news release.

As the calendar turns, more payers start returning your claims with ICD-10 codes. And Medicare will be watching to see how practices are doing with the new coding system. If you haven’t seen any return claims yet, don’t fret; you might not get them for a couple of weeks.

According to the release, “Medicare claims [generally] take several days to be processed and, once processed, Medicare must — by law — wait two weeks before issuing a payment. Medicaid claims can take up to 30 days to be submitted and processed by states.”