tci Medicare Compliance & Reimbursement - 2015 Issue 18
ICD-10 Transition: Take MAC's Help for ICD-10 Alternate Billing if You Face Issues
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Article Overview
This piece covers the Medicare ICD-10 transition period and focuses on CMS testing, claims processing readiness, and temporary billing alternatives for providers encountering implementation issues. It is aimed at billing staff, coders, practice managers, and other healthcare reimbursement professionals who need to understand the transition timeline, testing status, and where to look for support from their MAC or CMS resources.
Why This Topic Matters
The transition to ICD-10 affected claim submission workflows, payer acceptance, and practice operations. Readers need to know what CMS said about system readiness, what kinds of testing were available, and what fallback billing options may exist if their own systems were not ready.
Article Sections
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CMS readiness for ICD-10 implementation
Summarizes CMS comments on system preparation and the overall transition timeline. It frames the broader Medicare claims-processing context for the upcoming change.
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Testing Worked Out Kinks
Describes the types of testing CMS used to evaluate provider and system readiness. It also addresses common testing problems identified on the provider side.
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End-to-End Testing Helped Resolve Issues
Covers the completed end-to-end testing process and the role it played in validating claims flow. It notes participation levels and the general purpose of the testing rounds.
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Look for Alternatives if Your Systems are Struggling
Outlines general backup billing options for providers who are not ready to submit claims in the new code set. It also points readers to MAC and CMS resources for additional help.
What You Will Learn
- How CMS described Medicare system readiness for the ICD-10 transition
- What types of testing were used to prepare for implementation
- What kinds of claim submission issues surfaced during testing
- What general billing alternatives may be available if provider systems are not ready
- Where CMS directed providers to find transition-related resources
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Revenue cycle professionals
- Healthcare providers
- Medicare claims submitters
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