Wiki CMS: No Delay in ICD-10 Deadline

[KellyLR]

What does this mean? CMS will not pay any providers who fail to submit claims in ICD-10 after October 1, 2013. CMS published this in May on their website and it is in their ICD-10 FAQ section. The question posted asked if there would be a grace period for the implementation of ICD-10 compliance and CMS made it very explicit, the answer is NO. "October 1, 2013 is the compliance date for implementation of ICD-10-CM (diagnoses) and ICD-10-PCS (procedures) codes for services provided on or after October 1, 2013. There will be no delays and no grace period." CMS will not accept claims with ICD-9 codes on them after this date. In the provider resources section CMS encourages providers to get with the program and start implementation on schedule to avoid significant financial loss. The web site further read "If you are not ready, your claims will not be paid."

Hopefully, this will help others who have asked about ICD-10 implementation get an answer that is coming straight from CMS.

Best,

 

[mmorningstarcpc]

I believe it means for those that code/bill claims for DOS prior to and including September 30, 2013, but don't submit the claim till after October 1, 2013 for example, those claims will have to have ICD-9 codes. Anything filed with DOS October 1, 2013 and after, will need to be ICD-10.

It goes by DOS, not date claim is submitted, meaning claims can be submitted after October 1, just they need ICD-9 codes if DOS is prior to then.

 

[KellyLR]

Thanks for the clarification

Thanks! I got it when CMS wrote "services provided" to mean DOS!

 

[KellyLR]

Check out Coding Edge Aug issue

CodingEdge printed an article in this August's issue, pgs. 42-45 answering questions about ICD-10 implementation dates. Authored by Deborah Grider.Her is just one question answered by Ms. Grider:

Q2: Is the ICD-10-CM effective date based on service date
or submission date for outpatient services?
A: For all outpatient services, including ambulatory
and physician services, the date of service is the effective
date. For inpatient hospital facility reporting, if
the patient is admitted prior to Oct. 1, 2013 and discharged
after Oct. 1, 2013, the discharge date is the
key determining factor whether an ICD-9-CM code or
ICD-10-CM/PCS code is reported.

Enjoy!