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Clear Cut - July 2015 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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3 2 O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | J U LY 2 0 1 5 like this bring up a lot of questions. Would Medicare reimburse the center for only the codes listed in the payment rule and exclude the others, or would the entire claim be rejected because it included codes not payable? Listing excluded services on a claim with covered services would not typically result in a claim rejection, according to staff at CMS headquarters in Baltimore. Instead, only the lines that are excluded from payment in ASCs would likely be rejected. C O D I N G & B I L L I N G With only a few months to go before the dead- line for implementing the ICD-10 code set, physicians at the 2015 AMA Annual Meeting last month agreed to seek a 2-year grace peri- od so that ICD-10-based claims submitted to Medicare and Medicaid after the expected switch in October would not be denied or with- held due to coding errors, mistakes or mal- functions in the system. The American Medical Association says a grace period would let doctors more easily transition to the complex system without affecting patients' care or their bottom line. AMA had previously asked the government for another ICD-10 delay, saying the switch will "significantly over- whelm" physicians with its 400% increase in the number of codes used to document diagnosis and treatment of patients. "We continue to press both Congress and the administration to take necessary steps to avoid widespread disruption to physician practices created by this overly complex and burdensome mandate," says Russell W.H. Kridel, MD, AMA board member. "Coding and billing protocols should never get in the way of patients receiving high quality care." — Kendal Gapinski OCT. 1 ICD-10 DEADLINE Doctors Ask for 2-Year ICD-10 Grace Period Pamela Bevelhymer, RN, BSN

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