ICD-10 ‘grace period’ ending soon, but don’t panic
Written by Mark Painter and Ray Painter, M.D
We are a mere 2 months away from the anniversary of the great ICD-10 implementation. Oct. 1, 2015 turned out to be a Y2K-like non-event, with relatively few hiccups for most physician offices. The smooth transition was due, in part, to the agreement by Medicare and several other private payers to delay denial of claims and suspend chart audits based on lack of specificity of the ICD–10 code(s). The American Medical Association requested this phase-in, or “grace period,” which ends Oct. 1, 2016.
I’m a urologist in a large multispecialty group that specializes in men’s health. I see a lot of men with hypogonadism and have a large number on implantable pellets. I recently received a letter from an insurance company requesting that I repay all the money I received for evaluation and management visits on the same day as the implant. Are they correct? Is it against the payment rules for me to evaluate the patient on the same day as the implantation?