CMS ends ICD-10 claims auditing, quality reporting leniency Oct. 1

Brooke Murphy - Print  | 

CMS has updated its guidance on ICD-10 claims auditing and quality reporting for Part B physician fee schedule claims, noting this past year's leniency period will expire Oct. 1, according to the American Hospital Association.  

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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