305.995 Violation of HIPAA Electronic Transaction Standards by Insurer Failure to Upload ICD-10 Revisions
The Medical Society of the State of New York (MSSNY) will survey its members asking whether they have experienced claim denials, claims resubmission, or appeals because the insurer (federal, state or commercial) failed to upload the October 1, 2016, version of ICD-10 in a timely fashion.
Additionally, the Medical Society of the State of New York (MSSNY) will urge the American Medical Association (AMA) to present information on ICD-10 improper claim denials to the Centers for Medicare and Medicaid Services (CMS) and its Office of E-Health Standards & Services, to determine whether the insurers’ failure to properly update their claims processing systems has constituted a violation of the HIPAA Electronic Transaction Standards and should trigger disciplinary or corrective actions to prevent these occurrences in the future. (HOD 2017-253)
