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Part B Insider (Multispecialty) Coding Alert

Physician Notes:

ICD-10 Glitch Causes CMS to Slacken PQRS Requirements

The transition from ICD-9 to ICD-10 has had its fair share of ups and downs. But, a recent CMS release suggests that it might have been rockier than first suspected. Some ICD-CM (Clinical Modification) and PCS (Procedural Coding System) changes made on Oct. 1, 2016 weren’t updated properly to report measures for CY 2016.

Since these particular ICD-10 codes related to the Physician Quality Reporting System (PQRS) weren’t adjusted properly, CMS will be waiving penalties for eligible provider impacted by the glitch.

“CMS will not apply the 2017 or 2018 PQRS payment adjustments, as applicable, to any EP or group practice that fails to satisfactorily report for CY 2016 solely as a result of the impact of ICD-10 code updates on quality data reported for the 4th quarter of CY 2016,” CMS said in a Jan. 11, 2017 release. Read the CMS release here:

In a factsheet detailing the issue, CMS listed the following measures groups as being impacted under PQRS by the ICD-CM updates:

  • Diabetes
  • Cataracts
  • Oncology
  • Cardiovascular Prevention
  • Diabetic Retinopathy

Resource: See the CMS ICD-CM update fact sheet here: