Medicare Compliance & Reimbursement

Although most ICD-10 claims are flowing smoothly, practices are still facing glitches following the rollout of the new diagnosis coding system, which went into effect just over two months ago. The latest victims? Routine foot care and nail debridement claims, which are being denied inappropriately, one MAC recently announced.

“Some claims for routine foot care and debridement of nails have processed incorrectly since the transition to ICD-10,” said NGS Medicare in a Dec. 2 news blast. “NGS is adding some diagnoses as payable for these services and correcting edits which resulted in incorrect denials.”

While that’s good news for practices that were reporting payable services, NGS also had some bad news for practices whose claims didn’t meet Medicare payment criteria. “NGS has also identified submitted claims were paid for some services which did not meet overage criteria have been allowed in error.”

Therefore, whether your foot care claims were denied or paid inappropriately, the MAC is performing a mass adjustment to either pay or recoup reimbursement, so you don’t have to do anything to get the corrections made.