The Centers for Medicare and Medicaid Services (CMS) recently announced it is offering Medicare claim submission alternatives for providers who have difficulties submitting ICD-10 claims. Specifically, if your practice has been unable to complete the necessary systems changes or you are having issues with your billing software, vendor(s), or clearinghouses, the following claim submission alternatives are available:

 

  • Free billing software
  • Provider internet portals
  • Direct data entry
  • Paper claims (in limited circumstances) – Providers must apply for and meet all of the following requirements to qualify for a waiver of the Administrative Simplification Compliance Act provisions:

o Your software or software vendor is not ICD-10 ready, and it will cause a financial hardship for you to switch to another software or vendor; and

o Your Medicare Administrative Contractor’s provider Internet portal does not support electronic claims submissions; and

o It would cause financial hardship for you to procure the services of a billing agent/clearinghouse.


For more information, visit Medicare Learning Network Matters Number SE1522.

 

Please note: that while CMS is offering claim submission alternatives, they still require the use of ICD-10 code sets on and after October 1, 2015. Also, the claim submission alternatives offered above only work for Medicare claims and will not work for other claim types.

For questions or assistance, contact the ACCMA at 510-654-5383 or accma@accma.org.