CMS, AMA Announce 1 Year Grace Period on ICD-10 Codes

Date of Publication (July 15, 2015)

With less than three months remaining until the nation switches from ICD-9 to ICD-10 coding, the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) announced efforts to continue to help physicians get ready ahead of the October 1 deadline. For a one-year period starting October 1, 2015, Medicare claims will not be denied solely on the specificity of the ICD-10 diagnosis codes provided, as long as the physician submitted an ICD-10 code from an appropriate family of codes. In addition, Medicare claims will not be audited based on the specificity of the diagnosis codes as long as they are from the appropriate family of codes. This policy will be followed by Medicare Administrative Contractors and Recovery Audit Contractors. For more information, view CMS’ recently released guidance.

In response to CMS’ announcement to establish a one-year “grace period” on important elements of the ICD-10 transition,  IMS contacted Wellmark to see if they would be following CMS’ lead. When it is received, IMS will share Wellmark’s response.