Inpatient Facility Coding & Compliance Alert

Question: We have special arrangements to code office services for one of our physician groups. We’re wondering if we can expect National Coverage Determinations (NCDs) to replace applicable ICD-9 codes with the corresponding ICD-10 codes as the implementation deadline approaches. Have you heard anything about this? 

Wyoming Subscriber 

Answer: That’s a good question for every coder to know the answer to, because it’s an issue that can affect every facility and physician. The short answer is: Yes. 

 On Jan. 18, 2013, CMS instructed contractors to start the process of creating and updating NCDs that contain ICD-9 codes. CMS said that payers should assign comparable ICD-10 codes to them by the ICD-10 implementation date of Oct. 1, 2014. The directive was part of MLN Matters article MM8109.

Bonus: This should help practices immeasurably, since inclusion of applicable ICD-10 codes on NCDs could at least offer a window into how Medicare administrative contractors will view each new diagnosis code and which codes it deems payable for particular services.

Resource: To read the complete MLN Matters article, visit www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM8109.pdf.