Video: Every Case Tells a Story| Webinar: ACR/CHEST ILD Guidelines in Practice

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

  • Conditions
    • Axial Spondyloarthritis
    • Gout and Crystalline Arthritis
    • Myositis
    • Osteoarthritis and Bone Disorders
    • Pain Syndromes
    • Pediatric Conditions
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Sjögren’s Disease
    • Systemic Lupus Erythematosus
    • Systemic Sclerosis
    • Vasculitis
    • Other Rheumatic Conditions
  • FocusRheum
    • ANCA-Associated Vasculitis
    • Axial Spondyloarthritis
    • Gout
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Systemic Lupus Erythematosus
  • Guidance
    • Clinical Criteria/Guidelines
    • Ethics
    • Legal Updates
    • Legislation & Advocacy
    • Meeting Reports
      • ACR Convergence
      • Other ACR meetings
      • EULAR/Other
    • Research Rheum
  • Drug Updates
    • Analgesics
    • Biologics/DMARDs
  • Practice Support
    • Billing/Coding
    • EMRs
    • Facility
    • Insurance
    • QA/QI
    • Technology
    • Workforce
  • Opinion
    • Patient Perspective
    • Profiles
    • Rheuminations
      • Video
    • Speak Out Rheum
  • Career
    • ACR ExamRheum
    • Awards
    • Career Development
  • ACR
    • ACR Home
    • ACR Convergence
    • ACR Guidelines
    • Journals
      • ACR Open Rheumatology
      • Arthritis & Rheumatology
      • Arthritis Care & Research
    • From the College
    • Events/CME
    • President’s Perspective
  • Search

Prepare NOW for ICD-10 Medical Coding Transition

Kimberly Retzlaff  |  Issue: July 2015  |  July 14, 2015

Learning the new code structure will be a big transition, Dr. King says. “Some of the nomenclature that goes with the codes is not what we’re used to, and it’s not as intuitive as ICD-9. … For some diseases, instead of one code, there may be many codes to explain a single disease. There’s not always a one-to-one code conversion; it can be one to many or one to one, and that’s certainly challenging.”

The ACR has taken numerous actions to try to mitigate the burden of ICD-10 implementation on physicians, including offering training programs and workshops at various meetings nationwide, publishing online resources and information, and promoting legislation to protect physicians. In the legislative arena, the ACR signed a resolution passed at the American Medical Association’s November 2014 meeting to skip the implementation of ICD-10 and move directly to ICD-11, which is slated to begin beta testing in 2015.

Dr. Harvey

Dr. Harvey

Additional legislative work has continued, and ACR representatives spent all winter 2014–2015 working on proposed legislation. As a result, H.R. 2240 was introduced by Rep. Black (R-TN) in May. Dr. Harvey says the legislation has two components. First, it “requires CMS to offer end-to-end testing for anyone who wants [it] and [certify] to Congress that the system performs as well as the current one in terms of rate of denied claims; and next, [it establishes] a safe harbor period that prevents rejection of claims based on inaccurate subcode detail.”

The safe harbor period has been part of legislative efforts for over a year now. On Feb. 12, 2014, the AMA sent a letter to then Secretary of Health and Human Services Kathleen Sebelius, urging the CMS to reconsider ICD-10 implementation. One point was to encourage CMS to adopt a policy for Medicare that provides an “implementation” period during which payment cannot be denied on the basis of the ICD-10 code specificity.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

“We’re hoping there will be some period of time—ideally 18 months—where you use the ICD-10 code and you have to get the main part of the code right, but this specificity part we can get a pass for a period of time where we’re not held responsible for honest mistakes related to that,” Dr. Harvey explains.

Editor’s note: Since this article was written, the CMS has acted on the requests of the ACR and others and announced a one-year grace period during which it will not deny claims on the basis of incorrect ICD-10 sub-codes, so long as the correct family of codes is used. It also made some other concessions. See the related news.

Page: 1 2 3 4 5 6 7 8 9 | Single Page
Share: 

Filed under:Billing/CodingPractice Support Tagged with:BillingCodingDocumentationICD-10medicalPractice Managementrheumatologisttransition

Related Articles

    Plan Now for ICD-10 Changeover

    May 16, 2011

    Coding changes will have an impact on staff, physicians, and even the finances of rheumatology practices

    One-Year Transition Period May Ease the Pain of ICD-10

    August 25, 2015

    As the Oct. 1 deadline to transition to ICD-10 approaches, the CMS has released multiple resources, including a joint guidance statement with the AMA that details one year of claims leniency to help physicians adjust to the new coding system and smooth the transition process…

    Preparing for the Transition to ICD-10

    September 15, 2015

    The transition to ICD-10 is not just another yearly diagnosis codes update; it is a complete overhaul. This not only will affect providers, but also all payers, vendors and stakeholders are being affected by the expanded ICD-10 code sets through medical coding operations, software systems, reporting, administration, registration and more. With approximately 20 days before…

    2013–A Whole New World

    May 16, 2011

    ICD-10 will change the coding and billing landscape, and practices should start preparing now

  • About Us
  • Meet the Editors
  • Issue Archives
  • Contribute
  • Advertise
  • Contact Us
  • Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1931-3268 (print). ISSN 1931-3209 (online).
  • DEI Statement
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences