The ICD-10 grace period CMS announced July 6 does not apply to home health agencies.
 
Physician practices will have one more year after ICD-10’s Oct. 1 implementation to get their diagnosis coding exactly right. CMS and the AMA announced July 6 that a lack of code specificity will not cause claims denials for Part B providers. That announcement “was focused on physicians and other practitioners who bill under the physician fee schedule,” a CMS official explained to HHL.
 
Medicare administrative contractors (MACs) and recovery audit contractors (RACs) will be instructed not to deny practices’ claims “through either automated medical review or complex medical record review based solely on the specificity of the ICD-10 diagnosis code as long as the physician/practitioner used a valid code from the right family,” according to frequently asked questions (FAQs) that accompany the announcement.
 
Contractors will not assess penalties based on ICD-10 code use in reporting, nor will they deny eligible providers’ (EPs’) informal review requests, so long as “a valid code from the right family” is used, the right number and type of measures in appropriate domains have been submitted for the specified number/percentage of patients and the errors are related only to the specificity of the ICD-10 diagnosis code, according to the FAQs.
 
Home health experts caution agencies to continue preparing for ICD-10 as home health payments will be derived from accurate and specific codes starting October 1, 2015.
 
CMS has scheduled a National Provider Call scheduled for Aug. 27. The CMS FAQ may be found here: https://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD-10-guidance.pdf. AMA President Steven J. Stack's editorial can be found here: http://www.ama-assn.org/ama/ama-wire/post/cms-icd-10-transition-less-disruptive-physicians.