CMS Releases Stats on ICD-10 Transition
Jesse Hamby
October 29, 2015

CMS reports a smooth transition by Providers in using ICD-10 codes. As of 10/1/2015, Providers subject to HIPAA were mandated to use the new code set with over 64,000 codes compared to the roughly 14,000 codes that was available for ICD-9. The greater accuracy of the new code set will no doubt improve Medicare’s coordination of benefits, and RREs have been notified that they should pay close attention moving forward.

RREs must use ICD-10 codes for every claim involving a Date of Injury on or after 10/1/2015 when submitting Section 111 data. For claims with a Date of Injury on or before 0/30/2015, the RRE can use either ICD-9 or ICD-10, but must elect for each claim, what version they will report. Once elected, only that version of codes may be submitted, otherwise the claim will be rejected and potentially subject to penalties of up to $1,000 per day.

CMS reports that with the transition they are now receiving from Providers roughly 4.6 million records per day. They do not expect any delay in the prompt payment of Provider claims based on the date of loss.