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EFFORTS MADE TO HELP PREPARE FOR OCT. 1 TRANSITION

CMS and AMA provide guidance, assistance ahead of ICD-10 deadline

By Zack Tertel, Senior Editor

As the Oct. 1 switch from ICD-9 to ICD-10 approaches, the Centers for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) announced efforts to assist physicians.

At the AMA’s request, CMS announced a yet-to-be-named CMS ICD-10 Ombudsman to help answer questions about claim submissions. The ombudsman’s exact role remains unclear, but the position indicates that the physicians will have a direct voice when ICD-10 implementation or claim filing issues arise, according to Paul M. Larson, MBA, MMSC, COMT, COE, CPC, CPMA, a senior consultant at Corcoran Consulting Group. “They have someone they can send their members to who has the ear of CMS,” he says.

Also, free assistance from CMS includes the “Road to 10” primer for small physician practices, which includes clinical documentation, clinical scenarios, and other resources. In addition, the AMA provides materials to help physicians with their transition to ICD-10, along with the AMA Wire (http://www.ama-assn.org/ama/ama-wire/blog/ICD-10/1), which includes ICD-10 news and developments.

Mr. Larson says the fact that the CMS and AMA released a joint statement with these announcements was a surprise, potentially showing that the AMA will not resist the Oct. 1 ICD-10 implementation. It’s important to note that a bill introduced in May by Tennessee Republican Rep. Diane Black, the ICD-TEN Act, or Increasing Clarity for Doctors by Transitioning Effectively Now, aims to institute an ICD-10 transition period and has not been withdrawn

Along with these resources, CMS announced a one-year grace period for ICD-10 claims, stating that claims won’t be rejected for payment if it’s not specific enough. Details regarding the leeway granted for specificity remain to be seen, Mr. Larson says. “The question is, if you have a six-character code, would they let you get away with three, four, or five, or six characters if one of the ending characters is the wrong one? No one knows right now.”

Along with the leeway allowed on claims processing, CMS says they will not issue penalties if physicians submit data that contains less-than-perfect ICD-10 codes to Physician Quality Reporting System (PQRS) and other Medicare quality programs. Physicians will be expected to use a code from the correct ICD-10 family to avoid a penalty, although the codes that constitute the correct family are undetermined. “I think they’re trying to make it possible to allow a larger percentage of those who are going to have trouble to continue to get paid with minimal impact,” Mr. Larson says.

Still, ophthalmic practices can avoid any confusion by using the available resources to learn how to correctly code for ICD-10. “It is at least clear to all of us that if you file the perfect code now you have no problems, and you won’t have any problems moving forward,” Mr. Larson says.

HOPEFUL WAYS’ PREVIOUS TRIP SERVED MORE THAN 2,600 PATIENTS

Nicaraguan eye care medical brigade seeks volunteers, donations

By Susan O’Brien, COT

Hopeful Ways, a non-profit organization that brings eye care to the people of Nicaragua, is looking for ophthalmic personnel to volunteer to help on their January 2016 trip.

Their recent trip to Camoapa Boaco, Nicaragua, a poor mountainous ranching community two hours northeast of Managua, was the first medical brigade to visit Camoapa. The two-week project served more than 2,600 patients, dispensed thousands of eyeglasses and hundreds of sunglasses, performed 81 eye surgeries and fitted 15 prosthetic eyes. However, one-third of the people arriving to be treated were turned away as volunteers did not have enough time to treat the volume of patients.

You can help Hopeful Ways by organizing and/or traveling to Nicaragua. Medical training is not required to participate, but a wide range of skill sets are needed. In addition, Hopeful Ways accepts donations of prescription eyeglasses, reading glasses, sunglasses and safety glasses. Also, you can make tax-deductible donations by check payable to “Hopeful Ways” and mailed to: PO Box 1037, Getzville, NY 14068.

Susan O’Brien, COT, was one of 29 medical professionals who volunteered to help bring eye care to the people of Nicaragua.COURTESY: HOPEFUL WAYS

For more details about the trip, visit www.hopefulways.org. OP