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Does Your Clinical Documentation Hit the Specificity Target?

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On July 6, 2015, the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) announced joint efforts to help physicians prepare for ICD-10.  Included in that announcement was additional guidance from CMS allowing for flexibility in the claims auditing and quality reporting process.  Specifically, CMS established a 12-month “grace period” post implementation in which Medicare contractors would not deny claims billed under the Medicare Part B (outpatient) physician fee schedule if the ICD-10 code was incorrect, as long as a valid code from the correct family was used. The ICD-10 flexibility will end in one month, after which all physicians in the U.S. will be required to code to accurately reflect the clinical documentation in as much specificity as possible.  Those who don’t, risk an increase in rejected claims, fines and audits. As the October 1,..

The post Does Your Clinical Documentation Hit the Specificity Target? appeared first on The Galen Healthcare Solutions Blog.


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