ICD-10 Transition: Clarifications about NCDs and LCDs

(Source – CMS.gov)

All Medicare national and local coverage policies are translated for ICD-10, and to receive payment, providers must bill using ICD-10 codes for services rendered on or after October 1, 2015. Check the National Coverage Determination (NCD) and Local Coverage Determination (LCD) policies in the Medicare Coverage Database to find out which ICD-10 codes support medical necessity.

National Coverage Determinations

CMS received stakeholder feedback on certain NCDs and provided additional clarification. See MLN Matters® Article MM9252. Interim solutions are currently in place to permit appropriate claims payment. In most cases, claims were automatically reprocessed, and no action is required. A permanent systems update will be in place by January 4, 2016. Information about specific claim types and the reprocessing of claims is available on your Medicare Administrative Contractor (MAC) website.

Local Coverage Determinations

After implementation, some MACs identified LCDs that needed further refinements for ICD-10 diagnosis codes. Claims affected by these edits were temporarily suspended and automatically reprocessed. No action is required. Questions about specific LCDs should be directed to the appropriate MAC.

See the announcement for more information.

The ICD-10 Coordination Center Will Be Closed In Observance of Thanksgiving 2015

The ICD-10 Coordination Center (ICC) will be closed starting at noon Eastern Time on Wednesday 11/25/15 through Friday, 11/27/2015.  You may still send inquiries during this time. The ICC will begin responding to your inquiries again on Monday 11/30/15 at 8:30 AM Eastern.

Keep Up to Date on ICD-10

Visit the CMS ICD-10 website and Roadto10.org for the latest news and official resources, including the ICD-10 Quick Start Guide and a contact list for provider Medicare and Medicaid questions. Sign up for CMS ICD-10 Email Updates and follow us on Twitter.


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