Additional Updates to the WCMSA Reference Guide

CMS, ICD-10, Medicare Set-Aside Blog on April 18, 2016
Posted by Jean S. Goldstein, JD, CMSP

An updated and revised WCMSA reference guide was just issued today.  The revised guide, version 2.5, can be found here.

The revised WCMSA reference guide has two minor updates, both of which CMS has been addressing in the past couple of months, and which we have discussed here on our blog.  The first update piggybacks on the recent news and alerts, addressing ongoing responsibility for medical (ORM) recovery activities.  The update in the reference guide makes a specific note that Responsible Reporting Entities (RRE) are to use the Section 111 COB Secure Website for reporting.

Also, we recently reported the WCMSA portal confirmed that ICD-9 codes are no longer to be used for CMS submissions for cases with a date of injury on or after 10/01/2015.  The updated reference guide reflects this specification, and also notes that ICD-9 codes will be continued to be allowed for CMS submissions with a DOI of 09/30/2015 or earlier.  The guide also specifically notes, that both ICD-9 and ICD-10 codes should not be used on one submission.

As always, we will continue to monitor all CMS issued correspondence, and report any foreseeable compliance issues that may arise.