Outpatient Facility Coding Alert - 2017 Issue 1
ICD-10: Monitor Your Denials Since Grace Period Ended
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Article Overview
This piece is aimed at coding and billing professionals, especially in general surgery settings, who need to review denial trends after the ICD-10 grace period ended. It discusses payer comparisons, claims audits, diagnosis specificity, and the need to keep diagnosis code sets current as ICD-10-CM updates resume on an annual cycle.
Why This Topic Matters
Understanding whether denials increased after the grace period helps practices identify documentation gaps and payer-specific coding issues. Keeping diagnosis code sets updated is essential to avoid avoidable claim problems tied to outdated or incomplete diagnosis reporting.
Article Sections
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Monitor Returned Claims
This section discusses comparing claim results across payers after the end of the ICD-10 grace period. It focuses on denial trends, claims audits, and the need for greater diagnosis specificity in general surgery billing.
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Turn On Your ‘Update’ Mechanism
This section covers the importance of resuming regular diagnosis code-set updates after the ICD-10 transition freeze. It addresses the return of ongoing ICD-10-CM updates and the operational impact of outdated code sets.
What You Will Learn
- How to review denial patterns across major payers after the ICD-10 grace period
- Why diagnosis specificity affects claim outcomes
- Why regular code-set updates are necessary for ICD-10-CM maintenance
- How update freezes can affect diagnosis coding workflows
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle managers
- General surgery practices
- Compliance and coding supervisors
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