CMS Will End the ICD-10 Grace Period on October 1, 2016
Are you ready? The Centers for Medicare & Medicaid Services (CMS) have announced that the grace period for healthcare providers is to expire October 1st, 2016.
History of the ICD-10 Grace Period
This grace period was put into place when the rollout of ICD-10 began October 1st, 2015. The grace period meant that physicians would not be penalized for errors or mistakes made while adjusting to the new ICD-10 code specifications. It also protected physicians from being audited for not including the specificity of the diagnosis. The code did, however, need to at least be valid in the same family of codes. This grace period was set to last 12 months from its implementation date, which comes to an end October 1, 2016
CMS Will Not Extend Grace Period Flexibilities
As the 12-month grace period comes close to ending, CMS has stated that the ICD-10 flexibilities will not be extended past the original grace period end date. This means that providers must code with as much specificity as possible and coding must reflect the clinical documentation.
ICD-10 One Year Later
Leading up to the implementation of ICD-10 last year, it is easy to say that there was much apprehension among healthcare providers worried about maintaining compliance with the new guidelines. Overall, CMS reported that implementation went smoothly – with only .09 percent of codes rejected due to invalid ICD-10 codes.
In addition to the grace period ending on October 1st, 2016, healthcare organizations will need to be utilizing updated codes added to the system since the rollout.
How to Prepare for End of ICD-10 Grace Period
The following preparation for the ICD-10 grace period have been recommended by the CMS:
- Always use the specified, detailed codes when supported by documents.
- Double-check clinical documentation to ensure it aligns with ICD-10 coding
- Code each healthcare encounter to the exact level of certainty known
Further Guidance
Is your practice still experiencing high levels of denied claims? What about uncertainty with ICD-10 coding best practices? HIS is here to help your practice as the ICD-10 grace period comes to an end. We will assist you in achieving and maintaining compliance so that your practice sees higher levels of reimbursements. Contact us today to learn more about partnering with HIS.