CMS Issues Reminder Regarding Accurate Reporting of ICD-9 and ICD-10 codes for Ongoing Responsibility for Medicals (ORM)

CMS, Conditional Payments, Mandatory Insurer Reporting, Medicare, Medicare Set-Aside Blog on December 29, 2015 | Posted by Erin O'Neill, PA-C, JD

CMS has indicated that effective January 1, 2016, claims processing contractors will begin to utilize information provided by workers’ compensation entities/insurers for the purpose of reporting Ongoing Responsibility for Medicals (ORM), to determine whether Medicare is able to make primary payment for those claims.

As they have done in the past, CMS emphasizes the importance of reporting accurate ICD-9 and ICD-10 codes as these codes will be utilized to determine if there are any conditional payments associated with the occurrence.

The notification can be found in the Downloads section of the Coordination of Benefits & Recovery Overview – What’s New Page

https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Coordination-of-Benefits-and-Recovery-Overview/Whats-New/Whats-New.html