Eli's Rehab Report
Get Your ICD-10 Coding Right The First Time
MAC puts providers on notice.
If you thought you might get a little leeway as ICD-10 takes effect, think again. When ICD-10 starts on Oct. 1, “please ensure that your claims report the most accurate and specific diagnosis that is available,” urges Medicare Administrative Contractor National Government Services (NGS) in an email to providers. “When the instructions are followed, claims payment will be facilitated, and this will reduce the need for claims re-openings to correct ICD-10 diagnosis coding errors.”
Instruction #1: “ICD-10 codes provide left, right and bilateral options,” the MAC reminds providers. “NGS expects providers to use the specific code that indicates right, left, or bilateral, not ‘unspecified site.’”
Instruction #2: “ICD-10 provides detailed codes referencing upper limb, lower limb, toe or finger location and other anatomical sites. NGS expects providers to use the specific code available.”
Instruction #3: Use the correct seventh digit, when applicable.
Tip: Providers should review ICD-10 versions of Local Coverage Determinations and Articles, available on the CMS Coverage Database, at www.cms.gov/medicare-coverage-database/overview-and-quick-search.aspx . “They are currently available under “Future” documents,” NGS says.
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