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  • Changes to ICD-10 Take Effect Oct 1

    With ICD-10 reaching its 1-year anniversary in the United States, the Centers for Medicare and Medicaid Services (CMS) has announced that the "grace period" for coding will end October 1. After that, CMS will become much less flexible about the codes it will accept. In response, APTA has created an opportunity for members to receive discounts on an online portal that helps physical therapists find the most specific ICD-10 codes.

    During the ICD-10 grace period, CMS accepted codes that were technically inaccurate, so long as they were from "the right family." According to CMS, adoption of the new codes has been a relatively smooth process, paving the way for the agency to require that providers accurately code to the highest level of specificity beginning in October—a requirement that will not be phased in. More information about the change can be found in a CMS questions-and-answers document available online (look for questions 23 through 33).

    Just in time for the changeover, APTA has announced the addition of an offer that could help members meet the new ICD-10 specificity requirements. Members are now eligible for discounts on Cypher, a cloud-based tool that can help PTs identify the most specific ICD-10 codes—including the additional 1,900 codes CMS added recently, and the more than 3,600 codes added in March. More information on the program is available at the Cypher Member Value Program webpage.

    Another important ICD-10 issue: Beginning October 1, providers must use the 2017 ICD-10 codes, which include new codes, as well as some revised and reorganized codes. The 2017 codes should be used for discharges occurring from October 1, 2016, through September 30, 2017, and for patient encounters occurring from October 1, 2016, through September 30, 2017. CMS offers a webpage with links to the 2017 codes.


    • Will there be an opportunity to preview Cypher before purchasing? Mary

      Posted by Mary Daulong -> @GY_E on 11/1/2016 12:54 AM

    • What discharge coding are you talking about? Do we suppose to come up with a new ICD-10 code when we discharge at patient?

      Posted by Arthur Baudendistel on 11/1/2016 3:27 PM

    • Hi Mary - Yes, there is a preview video demo on the APTA landing page: http://icdlogic.com/apta/

      Posted by APTA Staff on 11/2/2016 8:14 AM

    • Will there be more detailed info coming from the APTA regarding the 10/1/16 icd10 changes? Specifically, our outpatient clinic just recently had a claim denied by Medicaid (Wisconsin) stating the code we provided wasn't specific enough (M54.5 low back pain). As far as the resources we've checked, it is a valid code. We've used it successfullly through the entire past year. The referring physician in this case also used the same code. Any guidance would be appreciated.

      Posted by Lori Webster-Dahl on 11/2/2016 8:28 AM

    • Can we bill using the peanut code T78.01XD with the tree nut code T78.05XD together?

      Posted by Margaret Sherman on 11/23/2016 2:37 PM

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