ICD-10: Time Is Up! ICD-10 Implementation Starts in October

Why This Topic Matters

It helps readers assess whether their organization needs to prepare for ICD-10 claim submission, review, and payer-specific follow-up procedures during the transition period.

Article Sections

1. CMS transition timing and implementation overview

   Introduces the timing of the ICD-10 transition and the general Medicare claims-processing context. Explains the article’s focus on flexibility during the early implementation period.

2. Find Out What “Family of Codes” Means

   Explains the broad concept of code families within ICD-10 and discusses how related categories are organized. Uses selected examples to illustrate the general idea.

3. Look for a Quality Reporting Reprieve, Too

   Summarizes CMS guidance related to quality reporting, audit review, and penalties during the transition period. Addresses the general scope of flexibility for post-payment review activities.

4. Check Local Coverage Decisions For Required Code Specificity

   Describes how national and local coverage policies remain relevant during the transition. Notes the interaction between coverage requirements, claim validity, and rejected or denied claims.

5. Advanced Payments May be Available If Contractors Experience Major Problems

   Covers operational contingencies if Medicare contractors experience processing disruptions. Mentions conditional advance payment procedures and CMS implementation support activities.

6. What About Medicaid Claims?

   Addresses how the CMS guidance differs for Medicaid claims and summarizes state Medicaid processing expectations. Notes the broader billing context for dual-eligible and Medicaid-covered patients.

7. Don’t Expect Commercial Payers to Follow Medicare

   Discusses the possibility of payer-specific differences outside Medicare fee-for-service. Highlights that commercial payer policies may vary during the transition.