Clarification on ICD-10 "Flexibility"

August 7, 2015

CMS has published an FAQ containing important clarifications regarding their flexibility on ICD-10 specificity come October 1.  


The Center for Medicare & Medicaid Services (CMS) announcement of July 6th regarding a “grace period” and family of codes has been clarified.  Important issues to note are:


  • It only applies to Medicare claims,
  • It only applies to Part B fee for service claims,
  • It only applies to post-payment reviews,
  • 7th characters are required when applicable,
  • Laterality is required, when applicable,
  • It does not apply to pre-authorizations required by Part C plans,
  • It does not apply to failure to meet an NCD or LCD.


Read more about this important clarification here.  

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