After Oct. 1, ICD-9 Clinical Modification will not be available for reporting purposes. ICD-10 CM will be the standard diagnostic code set. This section of the Member Update contains links to ICD-10 training and helpful information for Dentists.
CMS Webcast
CMS has created a series of webcasts to review the effect of ICD-10 on specific services. The Dental webcast can be accessed by clicking the link below.
Per KMAP Dental Bulletin 15189, "Effective with Medicaid claims received on and after July 25, 2015, the 2012 version of the ADA Dental Claim Form is required for dental services. Dental services billed on any other version will be returned to the provider." Click a link below for the complete bulletin from KDHE or guidance from the ADA. KMAP Dental Bulletin 15189
The following guidance was recently provided by Trisha Harkness, Synōvim's Senior ISS Services Consultant, when asked to define "legal health record set" and "designated record set".
"I typically think of the legal health record as the patient care information that would be provided if audited by an insurance company for medical necessity, for a patient moving or transitioning to a different primary care provider to ensure continuity of care or the information that would be provided to support care decisions during a malpractice investigation. The designated record is typically broader and often includes protected health information that may be unrelated to direct patient care such as billing records; keep in mind that patients are legally allowed under HIPAA to request a copy of their designated record set.
Especially when working with an EHR, I highly recommend that the practice review the capabilities of the EHR to ensure that the printed or electronic legal record and designated record set do not include internal notes or comments. For example, make sure "sticky notes" that the patient tends to be talkative or pop-ups that indicate a patient's payments are behind will not print on the record."
Health Center Connections is a health center controlled network organized and supported by KAMU. Current funding for Connections is through Health Resources and Services Administration (HRSA) HCCN Funding Opportunity HRSA-13-237.
