Medicare says “Unspecified ICD-10 Codes” are good enough to be paid, but Georgia Medicaid says no. For more information, review the Georgia Department of Community Health ICD-10 FAQ.
Q: Could you explain the Medicaid policy on unspecified codes and the requirements for ICD-10 effective October 1, 2015?
A: NOS, or “not otherwise specified” codes will be denied as there is not enough clinical documentation to determine the diagnosis.… Read More
Healthcare payers are talking a bit about how they’re handling ICD-10. Before Oct. 1, it was understood that the larger healthcare providers with abundant resources were the most prepared for ICD-10 implementation. It looks like the same can be said for healthcare payers. The bigger payers are in better shape. Apparently some of the smaller ones had to switch back to ICD-9 codes for processing medical claims. … Read More
I just read your post, “ICD-10: Learning from an industry’s aversion to change.” You are so right. We must learn from our mistakes. I really don’t understand why implementation of ICD-10 was delayed for 20 years. The longer you put something off, the more complicated and stressful the transition process becomes.… Read More
There’s no turning back now. After years of so much debate and delays, we have proceeded with the monumental transition from ICD-9 to ICD-10. Now that ICD-10 is finally here, it’s time to look back at lessons we can learn and apply to future healthcare change. Was it the infrastructure of our health IT system or the scope of the coding change that caused such concern and delay?… Read More
As a result of a Freedom of Information Act request, CMS has released their internal Medicare Fee-For-Service Claims Processing ICD-10 Contingency plan. The document identifies various situations that CMS believed could occur and what actions the agency and/or its contractors would take should those circumstances arise.… Read More