ED Coding & Reimbursement Alert - 2011 Issue 30
Physician Note: CMS Clarifies Whether You'll Report ICD-9 Codes When Dates of Service Span ICD-10 Implementation Date
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Article Overview
This article discusses CMS guidance on diagnosis reporting for claims whose service dates cross the ICD-10 implementation date. It is relevant to physicians, hospital billing staff, coders, and revenue cycle teams who need to understand the general CMS clarification, the provider settings affected, and the related Medicare overpayment recovery note mentioned in the headline text. The piece references a CMS transmittal and outlines broad handling approaches by provider type without serving as a substitute for the underlying guidance document.
Why This Topic Matters
Claims that span a code-set transition date can be processed differently depending on provider type and setting, so billing teams need current CMS direction to avoid rejected or unprocessable claims and related payment issues.
Article Sections
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Overview of the ICD-10 transition issue
Introduces the billing question created when service dates cross the ICD-10 implementation date. It frames the general claim-processing problem for affected providers and facilities.
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CMS guidance in Transmittal 950
Summarizes the CMS transmittal referenced in the article and the role it plays in clarifying claim reporting during the transition period. The section also situates the guidance within Medicare administration.
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Provider-specific reporting approaches
Outlines the broad handling differences CMS describes for various provider settings, including hospital and non-hospital claim types. It highlights that reporting can vary by setting and claim structure.
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Resources and reference information
Points readers to the CMS transmittal cited in the article for further details. This section serves as a reference note rather than detailed instruction.
What You Will Learn
- How CMS addressed claims that span the ICD-10 implementation date
- Which provider categories are discussed in the guidance summary
- Why different claim types may be handled differently during the transition
- Where the article directs readers for the underlying CMS reference
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Hospital revenue cycle teams
- Practice managers
- Compliance staff
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