Healthcare News: CMS guidance clarifies instructions for reporting services spanning October 1

September 23rd, 2015

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This CMS-focused article explains how providers should handle claims and dates of service that cross the October 1 ICD-10 transition. It is relevant for hospital billing and coding staff who need to understand the general guidance in MLN Matters materials, including differences by bill type and the need to coordinate with individual payers.

Why This Topic Matters

Claims that span the ICD-10 implementation date can create billing and coding uncertainty. This guidance helps readers understand the scope of the transition-related instructions and where CMS points providers for additional clarification.

Article Sections

  1. CMS guidance for services spanning October 1

    Overview of the transition-related billing issue and the CMS guidance discussed in the article.

  2. Type of Bill 12X instructions

    Discussion of how one inpatient Part B hospital bill type is handled when dates of service span the implementation date.

  3. Type of Bill 11X instructions

    Discussion of how an inpatient hospital bill type is handled when discharge or through dates fall on or after the implementation date.

  4. Example bills and additional guidance

    Mention of example billing scenarios and a reference to additional CMS guidance for related situations.

What You Will Learn

  • How CMS addresses claims that span the October 1 transition period
  • How the article distinguishes guidance by bill type
  • Where CMS directs readers for additional transition guidance
  • What types of billing scenarios are highlighted as examples

Who Should Read This

  • Hospital coders
  • Billing staff
  • Revenue cycle teams
  • Compliance staff
  • Payer relations staff

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