CMS: Clearinghouses Can Provide Limited ICD-10 Assistance

CMS released information to clarify the role of clearinghouses in assisting the transition to ICD-10.

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Clearinghouses should not be expected to provide the same level of support for ICD-10 as they did for the HIPAA Version 5010 upgrade because the new code set is based on clinical documentation and provider information. Only clearinghouses that offer coding services will be able to tell providers which ICD-10 codes to use.

Clearinghouses can help with identifying claim problems and reasons for rejection, as well as provide guidance on fixing rejected claims. These services can be a helpful too for testing ICD-10 claims processing.

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