We turn to Medicare for guidance on this because we know that many payers also look to Medicare as an example to follow. Each Medicare Administrative Contractor (MAC) releases a “local coverage determination” (or LCD) for each specialty. Your MAC will have an LCD available for chiropractic physicians in your area. The easiest way to find yours is to use the Medicare Coverage Database, which can be found online at http://www.cms.gov/medicare-coverage-database/overview-and-quick-search.aspx#HowToUseThisSite (simply select your state and type in “chiropractic”).
The LCD for Utah (where ChiroCode is based) is only 11 pages long. It might be wise for every office to take a little time to read it over. It lists, among other things, acceptable ICD-9 codes for Medicare claims.
LCDs likely are going to be the first place to look for acceptable ICD-10 codes. There were rumors that the LCD with ICD-10 codes would be available in October 2013, but October has come and gone. According to MLN Matters Document No. MM8348 (see http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM8348.pdf), all LCDs with ICD-10 codes must be available in the Medicare Coverage Database by April 10, 2014.
Payers have indicated that they will not be able to accept ICD-10 codes prior to Oct. 1, 2014, but test claims will create an opportunity to see how everybody will handle these new codes. One Blue Cross Blue Shield plan sent out a letter to providers many months ago indicating that it will be able to accept test claims in early 2014. Medicare recently announced that it will have a testing period open from March 3 to March 7, 2014 (see http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM8465.pdf). Watch for more information about how you might be able to participate. In the meantime, get started now and you will be a lot less stressed when the deadline hits.
