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January 25, 2018


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Medical Coding News Archives

ICD-10 Conversion of National Coverage Determinations

 
March 15, 2013:

Beth Ford, RHIT, CCS, Clinical/Technical Editor

The Centers for Medicare and Medicaid Services (CMS) continues to work with Medicare administrative contractors (MAC) to convert national coverage determinations (NCDs) and local coverage determinations (LCDs) from ICD-9-CM to ICD-10. The conversion gives CMS the opportunity to be more precise and refine edits to more accurately reflect coverage determinations.

Not all of the more than 300 NCDs created for the Medicare program are deemed appropriate for conversion to ICD-10. Policies that predate the evidence-based medicine process, are no longer clinically relevant, and that pertain to services determined to be noncovered based on technology will not be converted.

The NCD conversion entails reviewing coverage policies and analyzing and applying general equivalence mappings (GEMs) to ensure appropriate translations. Code translations are then applied at the local level. LCDs undergo a similar process by individual MACs responsible for ensuring code system conversions under their jurisdictions.

MedLearn Matters articles continue to provide timely information about NCD translations. CMS will post links for converted NCDs with actual translations of the policy from I-9 to I-10, procedure translations, edits, and grouping in a new format to prepare the payment system and garner feedback before implementation. A dedicated contact address will be posted as the main mode of information for feedback on every MedLearn Matters article.

 

 
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