(Last Updated On: September 5, 2017)

To ease the transition to ICD-10, Medicare allowed certain flexibility when coding based on specificity.  Those flexibility exceptions will end as of October 1, 2016.  “ICD-10 flexibilities were solely for the purpose of contractors performing medical review so that they would not deny claims solely for the specificity of the ICD-10 code as long as there is no evidence of fraud. As of October 1, 2016, providers will be required to code to accurately reflect the clinical documentation in as much specificity as possible, as per the required coding guidelines.”  Read more about what codes will be valid and how this affects audits in this CMS/AMA joint announcement.

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