On Oct. 1, 2016, physician practices must adopt new or revised ICD-10 codes for dozens of procedures – nearly 400 codes for ophthalmologists alone. These updates affect every ophthalmologist. The updates change how you must code treatment of patients with diabetes, glaucoma and other conditions.
The Academy helped you transition to ICD-10 successfully. We’ll lead you to equal success in adopting these updated codes.
What You Need to Know
- Medicare: For all claims with dates of service on or after Oct. 1, 2016, you must use the updated ICD-10 codes. If you do not, CMS will reject all claims using the old codes and your practice will not get paid.
- Commercial payers: Some may take longer to update codes. This could result in claims denials and payment delays of a month or more. The Academy is monitoring payers’ websites closely and will keep you updated when payers announce their timing to adopt the revised codes.
- PQRS: Failure to adopt the updated codes by Oct. 1 could also jeopardize 2016 success in the Physician Quality Reporting System.
- IRIS Registry users: Physicians planning to report the Diabetic Retinopathy Measures Group must take the blood pressure for a sample of qualifying patients by Sept. 30 to ensure that they can report the measures group for 2016. The group's Measure 317 includes this requirement.