Medicare Compliance & Reimbursement

Although confusion about the ICD-10 transition abounds among medical practices, CMS aimed to assuage some concerns during a recent CMS open door forum on the topic.

For instance: The implementation date for ICD-10 remains Oct. 1, 2013, but after that date, carriers will accept ICD-9 codes for services with dates of services prior to Oct. 1, 2013 "for a period of time," noted Pat Brooks, senior technical advisor with CMS, during the call. However, CMS has not revealed how long after the ICD-10 implementation date it will accept those codes.

What this means: "When the time comes, practices will want to submit their claims for dates of services prior to Oct. 1, 2013 as quickly as possible," notes coder Liza Shuman with Health Care Consultants in Boston. "The phrase 'for a period of time' seems to indicate that they will only accept the old ICD-9 codes for a short duration, even for claims submitted for dates of service prior to Oct. 1, 2013."

Mapping resources: CMS provided a quick tour of its ICD-10 mapping system, which is posted on its Web site. The crosswalk, known as "general equivalency mappings" or "GEMs," will help practices convert the existing ICD-9 codes to the new ICD-10 codes, and vice-versa.

Software conversion: One listener asked the CMS officials how big of a role their software will play in converting ICD-9 codes to ICD-10.

Brooks noted that it's unclear whether software vendors will offer conversion products, but suggested that practices or facilities interested in converting large numbers of codes from ICD-9 to ICD 10 could automate the conversion on their own using the CMS GEM User's Guide as a resource.

"If you had a smaller project, a list of only 20 or 30 codes you personally wanted to convert, you probably could manually use the GEMs and make that conversion and check that in your books as well," Brooks said.