- THCA

Volume XXX, Number 10
October 2015

October is here and so is ICD-10

CLICK HERE for more information on the ICD-10 Transition.

AHCA reached out formally via correspondence to the Centers for Medicare & Medicaid Services (CMS) in August, to solicit much needed guidance regarding nursing facility transition from the International Classification of Diseases, Ninth Revision (ICD-9) to the International Classification of Diseases, Tenth Revision (ICD-10). To date, CMS has provided extensive ICD-10 educational resources.

However, there were several questions specific to SNF services that the CMS resources did not address and we have been working with CMS since that time. Last Tuesday, AHCA received the attached responses.

Starting October 1st, healthcare providers must submit valid ICD-10 diagnosis codes on claims and required patient assessments, including the SNF Minimum Data Set (MDS), to receive payment. Key clarification points in CMS correspondence include:

The ICD-10 Ombudsman will be available to help answer nursing facility questions and can be reached at ICD10_Ombudsman
@cms.hhs.gov.
Minimum Data Set (MDS) assessments with Assessment Reference Dates (ARDs) on or before September 30, 2015 must contain a valid ICD-9 code in Section I if a diagnosis code is necessary. SNF MDS assessments with ARDs on or after October 1, 2015 must contain a valid ICD-10 code. CMS will reject MDS assessments if a Section I diagnosis code version does not apply for the ARD entered.

AHCA recommends that SNF clinicians, MDS assessment coordinators, and Billers review the Q&A document before submitting claims and MDS assessments that include October 2015 dates of service.

AHCA will continue to keep an open dialogue with CMS to answer questions as they occur. Members that submit concerns to the CMS ICD-10 Ombudsman are also encouraged to report such issues to AHCA so that we can quickly identify issue trends and facilitate efforts with CMS as seeking quick resolution of problems. AHCA has created an ICD-10 Implementation issues mailbox at icd10@ahca.org for this purpose. NOTE: When sending such issues to the AHCA mailbox, please do not include any beneficiary personally identifiable information (PII), or personal health information (PHI).

Please do not hesitate to contact Dianne De La Mare at ddmare@ahca.org or Dan Ciolek at dciolek@ahca.org if you have other specific ICD-10 Implementation questions (other than how to code) that we should be discussing with CMS.

President’s Report

President’s Report

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Legislative Update

Senator Kolkhorst Honored as Long Term Care Champion

THCA Joins Events for Texas Congressmen

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Commitment to Care

Commitment to Care – Topic of the Month
Have you Heard? About the One a Month Campaign

If you missed the Update of Quality Concerns in Dementia Care Webinar – Why Doctors Should Rarely Prescribe Antipsychotics in Texas Nursing Homes?

MDS Member Alerts

October is here and so is ICD-10

ICD-10 Prohibited HIV/AIDS codes for MDS 3.0

jRAVEN Software Version 1.3.0 Available

Resident Assessment Instrument (RAI) Manual v1.13 Released

MDS 3.0 Quality Measures Manual V9.0 Released

Important Payroll Based Journal (PBJ) Provider Action Items

MDS System-Generated Final Validation Reports Available in Text and XML Format

Did You Miss the MDS 3.0 Update Webinar on Sept. 28?

If you have any questions about the THCA C to C Initiative or would like to share your facilities successes please contact me at gbwilliams@txhca.org or call (512) 458-1257.

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