ICD-10: CMS: For First Year, We Won't Deny Claims With Wrong ICD-10 Codes

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

Article Overview

This article covers CMS and AMA guidance issued during the ICD-10 transition period. It is aimed at physicians, practices, billing staff, and coders who need to understand how the agencies planned to handle claims processing, reporting programs, implementation support, and temporary administrative relief after ICD-10 go-live. The article focuses on general transition policies, communication resources, and how CMS described its approach to claims and reporting issues during the first year.

Why This Topic Matters

The guidance described here affected how practices prepared for ICD-10 implementation and what they could expect if coding or system issues occurred during the transition period.

Article Sections

  1. ICD-10 transition guidance from CMS and AMA

    An overview of the joint announcement and the context for the transition-related guidance. The section introduces the organizations involved and the timing of the update.

  2. Support resources during the transition

    Discussion of communication support, an ombudsman role, and related help resources for practices facing implementation questions.

  3. Claims processing and temporary flexibility

    General discussion of Medicare claims handling during the first year after implementation and the circumstances CMS addressed in its guidance.

  4. Quality reporting and payment programs

    Coverage of reporting programs affected by the transition, including CMS statements about temporary reporting-related concerns.

  5. Advance payments and administrative issues

    Summary of guidance related to MAC system problems, partial payments, and how administrative interruptions were described in the update.

  6. CMS and AMA outlook

    Closing comments on the agencies’ collaboration and their stated intent to continue supporting the transition.

What You Will Learn

  • How CMS and AMA framed support for the ICD-10 transition
  • What types of help resources were announced for providers
  • How CMS described temporary claims-processing flexibility
  • Which reporting programs were addressed in the guidance
  • What CMS said about administrative issues affecting Medicare processing

Who Should Read This

  • Physicians
  • Medical office staff
  • Coders
  • Billers
  • Practice managers
  • Compliance staff

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