Medicare Compliance & Reimbursement - 2013 Issue 5
ICD-10: Expect NCD Conversion from ICD-9 to ICD-10
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Article Overview
This article covers CMS guidance on converting National Coverage Determinations from ICD-9 to ICD-10 during the Medicare transition period. It is aimed at general surgery and coding professionals who need to understand how coverage-related diagnosis lists are being updated and how that affects payment support for services. The discussion focuses on the CMS crosswalk process, related MLN Matters communication, and the broad categories of diagnosis code updates involved.
Why This Topic Matters
Coverage policies tied to diagnosis coding can affect whether services are considered payable. Understanding the CMS transition process helps practices monitor which diagnosis groupings are being aligned for ICD-10 and prepare for the changeover.
Article Sections
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Crosswalk Plan
An overview of CMS instructions for updating coverage policies during the ICD-10 transition. The section discusses the general process of aligning existing diagnosis lists with the new code set and the related Medicare communication.
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Example diagnosis code transition
A brief illustrative discussion showing how a prior diagnosis code referenced in coverage policy is expected to map into multiple ICD-10 diagnosis options. The example is used to show the type of update practices may encounter.
What You Will Learn
- How CMS approached updating coverage-related diagnosis lists for the ICD-10 transition
- Why National Coverage Determinations matter for Medicare payment support
- What kinds of guidance practices should expect from CMS during the code set conversion
- How coverage policy updates may affect general surgery documentation and billing workflows
Who Should Read This
- General surgeons
- Medical coders
- Coding managers
- Billing staff
- Compliance staff
- Practice administrators
Codes Discussed
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