ICD-10 News: Clarifications about NCDs and LCDs

ICD-10. COMPLIANCE DATE OCTOBER 1, 2015

News Updates | November 20, 2015

ICD-10 Transition: Clarifications about NCDs and LCDs All Medicare national and local coverage policies are translated for ICD-10, and to receive payment, providers must bill using ICD-10 codes for services rendered on or after October 1, 2015. Check the National Coverage Determination (NCD) and Local Coverage Determination (LCD) policies in the Medicare Coverage Database to find out which ICD-10 codes support medical necessity. National Coverage Determinations CMS received stakeholder feedback on certain NCDs and provided additional clarification. See MLN Matters® Article MM9252. Interim solutions are currently in place to permit appropriate claims payment. In most cases, claims were automatically reprocessed, and no action is required. A permanent systems update will be in place by January 4, 2016. Information about specific claim types and the reprocessing of claims is available on your Medicare Administrative Contractor (MAC) website. Local Coverage Determinations After implementation, some MACs identified LCDs that needed further refinements for ICD-10 diagnosis codes. Claims affected by these edits were temporarily suspended and automatically reprocessed. No action is required. Questions about specific LCDs should be directed to the appropriate MAC. See the announcement for more information. The ICD-10 Coordination Center Will Be Closed In Observance of Thanksgiving 2015 The ICD-10 Coordination Center (ICC) will be closed starting at noon Eastern Time on Wednesday 11/25/15 through Friday, 11/27/2015.  You may still send inquiries during this time. The ICC will begin responding to your inquiries again on Monday 11/30/15 at 8:30 AM Eastern.

Informal Review for Payment Adjustments Ends 11/23

The MLN Connects® Provider eNews contains important news, announcements, and updates for health care professionals. Thursday, November 19, 2015 Can't view the image? Read the eNews! View this edition as a PDF In This Edition: MLN Connects® Events National Partnership to Improve Dementia Care and QAPI Call — Register Now Medicare Quality Reporting Programs: 2016 Physician Fee Schedule Call — Register Now ESRD QIP: Access PY 2016 Performance Score Report and Certificates Call — Register Now Announcements Registration for DMEPOS Competitive Bidding Round 1 2017 Closes November 20 CMS Awards Partnership-Driven Special Innovation Projects to QIN-QIOs Reducing Improper Payment: A Collaborative Effort Comprehensive Care for Joint Replacement Model Revised 2014 Annual QRURs Available 2016 Value Modifier Informal Review Deadline Ends November 23 2016 PQRS Payment Adjustment: Informal Review Deadline Ends November 23 Comments on Discharge to Community Quality Measure due November 23 Considering Opting Out of Medicare to Meet the Prescriber Enrollment Requirements? — Updated EHR Incentive Programs: New Public Health Reporting FAQs Recognizing Lung Cancer Awareness Month and the Great American Smokeout Claims, Pricers, and Codes ICD-10 Transition: Clarifications about NCDs and LCDs CY 2013 Referring Provider DMEPOS Data — Updated Medicare Learning Network® Publications Complying with Documentation Requirements for Laboratory Services Fact Sheet — New Skilled Nursing Facility Prospective Payment System Booklet — Revised Product Available in an Electronic Publication Format Like the eNews? Have suggestions? Please let us know! The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered trademarks of the U.S. Department of Health and Human Services (HHS).

Learn About EHR Stage 3 & More This Week

The MLN Connects® Provider eNews contains important news, announcements, and updates for health care professionals. Thursday, November 12, 2015 Can't view the image? Read the eNews! View this edition as a PDF In This Edition: MLN Connects® Events National Partnership to Improve Dementia Care and QAPI Call — Register Now Medicare Quality Reporting Programs: 2016 Physician Fee Schedule Call — Register Now ESRD QIP: Access PY 2016 Performance Score Report and Certificates Call — Register Now Other CMS Events LTCH Quality Reporting Program: In-Person Provider Training in Baltimore, MD Announcements Three DMEPOS Competitive Bidding Reminders for Round 1 2017 EHR Incentive Programs Stage 3 Final Rule: Submit Comments by December 15 New FAQs on Participation in EHR Incentive Programs CMS Seeking Comment on MACRA Episode Groups by February 15 Raising Awareness of Diabetes in November Claims, Pricers, and Codes Pap Smear and PET Scan Claims Editing Incorrectly Additional Logic Applied to MDC 14 Medicare Learning Network® Publications Selecting Home Health Claims for Probe and Educate Review MLN Matters® Article — Released Clinical Laboratory Improvement Amendments Fact Sheet — Revised Inpatient Psychiatric Facility Prospective Payment System Fact Sheet — Revised Products Available in an Electronic Publication Format  Like the eNews? Have suggestions? Please let us know! The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered trademarks of the U.S. Department of Health and Human Services (HHS).

ICD-10 News: New Physician Orders FAQ Clarifies CMS Requirements

ICD-10. COMPLIANCE DATE OCTOBER 1, 2015

News Updates | November 12, 2015

Providers Not Required to Revise Physician Orders Written Before Oct 1: New CMS FAQ In response to questions from the provider community, CMS posted a new FAQabout physician orders written before the October 1 ICD-10 compliance date. FAQ 12625 explains that CMS is not requiring the ordering provider to translate ICD-9 diagnosis codes to ICD-10 on orders written before October 1 for lab, radiology, or any other services.  In brief: Orders written before October 1 should have a ICD-9 codes. For orders written before October 1 for services that will continue to be delivered and billed after October 1, providers can opt to use the General Equivalence Mappings (GEMs) to translate the ICD-9 codes on the original order to ICD-10. Providers are not required to update codes to ICD-10 for orders written before October 1.  Orders written on or after October 1 must use ICD-10.  For more guidance on claims processing and billing, please visit the CMS ICD-10 FAQ webpage.  Keep Up to Date on ICD-10 Visit the CMS ICD-10 website and Roadto10.org for the latest news and official resources, including the ICD-10 Quick Start Guide and a contact list for provider Medicare and Medicaid questions. Sign up for CMS ICD-10 Email Updates andfollow us on Twitter.

Physician Compare Preview Period Ending in One Week!

Physician Compare Preview Period Ends on November 16, 2015 The Physician Compare preview period ends on Monday, November 16, 2015. The preview period provides an opportunity for individuals and group practices to review their 2014 quality measures before they are reported on Physician Compare later this year. Don’t miss your chance to preview your 2014 quality measures before they are publicly reported on Physician Compare. All selected measures will be publicly reported, so be sure to take this opportunity to preview. You can access the secured measures preview site now through the PQRS portal—Provider Quality Information Portal (PQIP). To learn more about which measures will be publicly reported andhow to preview your measures, visit the Physician Compare Initiative page. If you have any questions about Physician Compare, public reporting, or the 2014 quality measure preview period, please contact us at PhysicianCompare@Westat.com Centers for Medicare & Medicaid Services (CMS) has sent this Medicare.gov- Physician Compare Update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.

CMS Finalizes Medicare Payment Rules

The MLN Connects® Provider eNews contains important news, announcements, and updates for health care professionals. Thursday, November 5, 2015 Can't view the image? Read the eNews! View this edition as a PDF New Feature: Click to View Articles! MLN Connects® National Provider Calls and Events Clinical Diagnostic Laboratory Test Payment System Proposed Rule Call — Last Chance to Register National Partnership to Improve Dementia Care and QAPI Call — Register Now Medicare Quality Reporting Programs: 2016 Physician Fee Schedule Call — Registration Now Open ESRD QIP: Access PY 2016 Performance Score Report and Certificates Call — Registration Now Open New MLN Connects National Provider Call Audio Recording and Transcript Announcements Physician Fee Schedule: Policy and Payment Changes for CY 2016 Hospital Outpatient and ASC: Policy and Payment Changes for CY 2016 ESRD Facilities: Policies and Payment Rates for CY 2016 HHAs: Payment Changes for CY 2016 Discharge Planning Proposed Rule Focuses on Patient Preferences Final Waivers in Connection with the Shared Savings Program DMEPOS Competitive Bidding Round 1 2017: Covered Document Review Date November 16 Physician Compare Preview Period Extended to November 16 2016 Value Modifier: Informal Review Deadline Extended to November 23 2016 PQRS Payment Adjustment: Informal Review Deadline Extended to November 23 Part D Prescribers Must Enroll in Medicare: Submit Your Application by January 1 Considering Opting Out of Medicare to Meet the Prescriber Enrollment Requirements? CMS to Release a Comparative Billing Report on Physical Therapy in November November is Home Care and Hospice Month Each Office Visit is an Opportunity to Recommend Influenza Vaccination Find Information on Medicare-Covered Preventive Services Claims, Pricers, and Codes Colorectal Cancer Screening Claims Processing Issue FY 2015 Inpatient PPS PC Pricer Update Available FY 2015 HH PPS PC Pricer Update Available Medicare Learning Network® Educational Products Medicare Learning Network Catalog: November 2015 Version Available “ICD-10-CM Diagnosis Codes for Bone Mass Measurement” MLN Matters Article — Released “Medicare FFS Claims Processing Guidance for Implementing ICD-10” MLN Matters Article — Revised Medicare Learning Network Products Available in Electronic Publication Format Like the eNews? Have suggestions? Please let us know! The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered trademarks of the U.S. Department of Health and Human Services (HHS).