CMS Releases FAQ on How to Use ICD-10 Qualifiers; Provides Update on Claims Processing Since Transition

This week, CMS reminded providers that claims with ICD-10 diagnosis codes must use ICD-10 qualifiers. CMS released FAQ 12889 with additional information on how to use ICD-10 qualifiers.  

In addition, CMS’ has provided updated Clarifying Questions and Answers related to the ICD-10 flexibility guidance, and providers may contact CMS’ ICD-10 Coordination Center if they have ICD-10 questions. Providers may also contact the ICD-10 Ombudsman, who is an impartial advocate for providers’ ICD-10 concerns.

This week, CMS released preliminary statistics on claims processed and denied using ICD-10. Since the transition, CMS reports that 2% of claims were rejected due to incomplete or invalid information, which is equal to historical trends. Only 0.09% of claims submitted have been rejected due to invalid ICD-10 codes, which is less than the estimate 1.7% based on previous end-to-end testing. Overall, 10.1% of claims have been denied since October 1, slightly higher than the historical figure of 10%.

As you know, ASCRS•ASOA has also created an ICD-10 Resource Center to assist members in preparing for the ICD-10 implementation, which includes ASCRS•ASOA ICD-10 materials, CMS ICD-10 resources, information on upcoming ASOA ICD-10 training events, and information on how to get your ICD-10 questions answered.