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Medicare Takes Steps to Make NCDs Reflect ICD-10-CM Codes

October 25, 2012:

Melinda Stegman, Clinical/Technical Editor

On September 14, 2012, the Centers for Medicare and Medicaid Services released ICD-9-CM to ICD-10-CM crosswalks for certain national coverage determinations. These crosswalks are essential components of the operational changes needed to convert Medicare shared system diagnosis codes specific to particular NCDs from ICD-9-CM to ICD-10-CM in anticipation of the full transition to ICD-10 codes in 2014. All Medicare claims must list only ICD-10-CM codes as of October 1, 2014.

NCDs contain the diagnosis codes that support any given CPT procedure code. All these diagnosis codes must be translated to ICD-10 codes before October 2014. The changes to the shared systems, the software sent to all Medicare billing and reimbursement contractors to process claims, will be phased in gradually and will not affect current adjudication. The shared systems will begin implementing the necessary changes to the NCDs in the January 2013 systems release. The changes will in no way alter existing Medicare coverage.

Transmittal 1122 (change request 7818) creates and updates hard-coded Medicare shared system edits in NCDs by replacing the ICD-9-CM codes with corresponding ICD-10-CM codes. This transmittal also includes relevant editing, such as procedure codes, denial messages, and frequency edits.

Edits relating to durable medical equipment Medicare administrative contractors will be addressed in future transmittals.

An article explaining the changes to providers can be accessed.


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