During the first year following ICD-10 implementation, Medicare review contractors could not deny physicians’ claims if the physician did not code to the highest level of specificity as long as there was no evidence of fraud. Physicians were also exempted from the physician quality reporting system value based modifier.
As of Oct. 1, providers will be required to code and reflect clinical documentation in as much specificity as possible. To avoid claims rejections, CMS recommends providers review its 2016 ICD-10 coding guidelines.
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