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ICD-10 Codes

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October 6, 2020

CMS releases new NGHP Section 111 User Guide (Version 6.0) and updated accepted/excluded ICD code listings

On 10/5/20, CMS released an updated Section 111 NGHP User Guide, Version 6.0. They also released updated versions of accepted and excluded ICD-9 and ICD-10 codes for…

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August 14, 2020

CMS holds Section 111 NGHP update webinar

On 8/13, CMS held a webinar on Section 111 non-group health plan reporting. The webinar covered NGHP Section 111 reporting best practices and MSPRP enhancements.

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June 9, 2020

Insurance fraud detection in action: Identifying suspicious medical billing during the COVID-19 crisis

Taking a closer look at medical billing helps identify pandemic-related issues that can put patients at risk and negatively impact insurers’ bottom lines.

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April 9, 2020

Medicare enables COVID-19 ICD-10 code for Section 111 reporting

The CDC issued a bulletin advising it is implementing the new ICD-10 U07.1 for “COVID-19, virus identified” in an off-cycle update effective 4/1/20, to code the COVID-19…

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October 23, 2019

CMS releases new NGHP Section 111 user guide (Version 5.7)

On 10/7/19, CMS released an updated Section 111 User Guide (Version 5.7) regarding non-group health plans (liability, no-fault and workers’ compensation).

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October 7, 2019

Conditional payment updates | Open Debt Reports are back; Pre-PCN worksheets are on hold; and CRC will continue to review all CPL disputes

There has been a flurry of recent activity from the Centers for Medicare and Medicaid Services (CMS) and the Commercial Repayment Center (CRC) regarding processing of…

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June 14, 2019

Avoiding penalty problems by ensuring data accuracy

With CMS (Centers for Medicare and Medicaid Services) penalties on the horizon, we’ve been exploring how RREs (Responsible Reporting Entities) can be proactive in…

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May 22, 2017

New realities: The Section 111 connection to conditional payments and claim outcomes

Section 111 reporting used to be viewed as an abstract technical Medicare compliance obligation & IT's responsibility because of the data transmission.

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May 17, 2017

Risky business: Five essential tips for Section 111 reporting

Your Section 111 reporting program may seem clear-cut, but it can mean risky business if your team isn’t prepared to avoid common compliance mistakes.

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December 31, 2015

New CMS claims payment process begins January 1, 2016

On December 24, 2015, the Centers for Medicare and Medicaid Services (CMS) issued a reminder that its claims payment process for ongoing responsibility for medicals (ORM)…

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September 22, 2015

Preparing for ICD-10: are you ready?

For the past year, it’s been difficult to overlook the numerous reminders from the Centers for Medicare and Medicaid Services (CMS) regarding the upcoming transition from…

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February 20, 2015

ICD-10 update

One of the most important developments in Medicare Secondary Payer compliance for 2015 will be the transition from ICD-9 codes to ICD-10 codes on October 1, 2015. On that…

Preparing For The Icd 10 Transition
August 7, 2014

Preparing for the ICD-10 Transition

CMS released an alert in May 2014 announcing that the ICD-10 diagnosis codes reporting for Section 111 is postponed until October 1, 2015.