ASCRS and Medical Community Seek Clarification from CMS Regarding the Impact of New ICD-10 Codes on 2016 PQRS Measures; New ICD-10 Codes Go into Effect October 1

ASCRS•ASOA, in conjunction with the AMA, has reached out to the highest levels at CMS to address the issues created by the updated ICD-10 codes effective October 1, and the impact on quality reporting—particularly Measure 317, Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up, that is included in the Diabetic Retinopathy Measures Group but can also be reported as a stand-alone measure when reporting the required nine measures. In addition, the ICD-10 update impacts other codes and measures, and has broad ramifications beyond just ophthalmology. CMS has responded to our inquiry and notified us that it is working to address the issue for 2016 PQRS reporting quickly. ASCRS•ASOA will send an alert to all members when we receive additional information from CMS.

On October 1, updates to ICD-10 will go into effect. New code sets can be accessed on CMS’ website. As a reminder, the one-year grace period implemented prior to the conversion from ICD-9 last year will expire on October 1. CMS originally instituted the grace period, wherein claims would not be rejected solely due to errors in code specificity, following ASCRS and medical community advocacy. In preparation for the end of the grace period, CMS released additional updates to its FAQ document this week.