BC Advantage - 2015 Issue 9

ICD-10: Most private payers won't offer grace period like CMS

Most commercial payers will not offer a oneyear grace period for ICD-10 codes like CMS, DoctorsManagement has learned. Starting on Oct. 1, you'll only need ICD-10-CM diagnosis codes of the correct code family to have your Medicare claims paid, and CMS will not deny claims based on the specificity of ICD-10 codes alone. However, specificity for your commercial payers will vary. So far, only Humana has stated explicitly that it will observe a 12-month grace period like CMS starting in October. CMS officials have made it clear that the agency has no control over whether commercial payers offer a...

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