ED Coding & Reimbursement Alert - 2016 Issue 1
Reader Question: Avoid ICD-9 and ICD-10 on Single Claim
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Article Overview
This reader question and answer addresses claim submission timing around the ICD-10 transition. It is aimed at coders, billers, and revenue cycle staff who need general guidance on how claims spanning the implementation date are handled, including a noted exception discussed in CMS guidance. The article also points readers to CMS MLN Matters material for additional context.
Why This Topic Matters
Claims that cross major code-set implementation dates can create submission and payment issues if handled incorrectly. Understanding the general billing approach helps avoid unprocessable claims and supports cleaner transition-period processing.
Article Sections
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Question
A billing scenario is presented involving services that span the ICD-10 implementation period. The question asks how the claim should be handled when different diagnostic code sets may apply to different dates of service.
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Answer
The response provides general guidance on claim submission during the transition period and refers to CMS policy and related Medicare learning network material. It also notes a special circumstance discussed in the source article.
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Read more
This section points to a CMS resource for additional information on the topic. It serves as a reference for readers who want to review the source guidance directly.
What You Will Learn
- How the article frames claim handling when service dates cross the ICD-10 transition period.
- What general type of CMS guidance is referenced for transition-period billing.
- That the article includes a noted exception involving a specific claim type and date span.
- Where the article directs readers for further official reference material.
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle teams
- Practice managers
- Compliance staff
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