CMS Provides ICD-10 Flexibility to Physicians Only
September 10, 2015 11:25 AM
After multiple requests to the Centers for Medicare & Medicaid Services (CMS) to clarify whether home health and hospice agencies will be provided the same ICD-10 coding flexibility as permitted for physicians, the National Association for Home Care & Hospice (NAHC) received the following response:
“Thanks for your patience on this topic. CMS is not extending coding flexibility to other providers. The reason we focused on claims billed under the Part B physician fee schedule is because many physicians practice in small practices that need additional flexibility to gain experience with the ICD-10 coding set. And, claims billed under the Part B physician fee schedule are primarily paid using CPT codes and not ICD-10 codes. Other services, such as institutional services, are paid based on the ICD-10 codes.
“We have named our ICD-10 Ombudsman who will listen to issues raised by all suppliers and providers and will evaluate any specific issues that are raised during implementation. CMS’s ICD-10 Coordination Center will be actively monitoring for any problems that may develop after October 1. This center will quickly identify and initiate resolution of issues that arise as a result of the transition to ICD-10.”
NAHC is disappointed by CMS’ decision to provide only physicians relief for 12 months from consequences related to ICD-10 coding errors. NAHC has concerns that physicians will not have any incentive to provide agencies with information necessary to code to the level of specificity required by ICD-10 coding guidelines. We will continue to pursue CMS to provide flexibility for home health and hospice providers. We also urge CMS to educate physicians on the need to share clinical documentation with providers when referring patients to home health and hospice.