SEP 22, 2016
Unspecified ICD-10 Codes Expire Sept 30
The one-year grace period for reporting unspecified ICD-10 codes will expire Sept.30, 2016. CMS implemented the grace period so auditors would not deny services based on the lack of specificity. However, it did not overrule any local coverage determination policies that were in effect.
Many other payers did not offer the same flexibility. While an unspecified code may be the only choice at times, physicians should otherwise code to the highest level of specificity. Be sure to verify which ICD-10 diagnosis codes are included in LCDs published by each Medicare Administrative Contractor to avoid unnecessary denials. For more information, read the CMS announcement regarding ICD-10 Flexibilities.