ICD-10


ICD-10 UPDATE: External Cause of Injury Diagnosis Codes (Diagnosis Codes Beginning with V, W, X or Y) Are now Billable as Non-Primary Diagnosis Codes 03/18/19

Attention All Behavioral Health Providers 04/06/16

ICD-10 Testing Information Update 09/18/15

ICD-10 QA 09/10/15

ICD-10 Implementation Webinar Presentation 08/7/15

ICD-10 Outreach 07/6/15

ICD-10 Information Update - 9/10/2015


A recent article published on the Modern Healthcare web site has caused concern to some of our Louisiana Medicaid providers about Louisiana’s readiness to meet the ICD-10 October 1, 2015 deadline. A link to this article is below. CMS mandated that states be able to accept ICD-10 codes by October 1, 2015. They did not mandate how processing was to take place. The article does not state that Louisiana will not be ready. Rather, it states the process of cross walking by Louisiana and 3 other states is a workaround and therefore a temporary solution. CMS has approved the method of cross walking in various forms based on each individual states' needs. Louisiana is ready for the conversion to ICD-10.

Article link below: http://www.modernhealthcare.com/article/20150904/NEWS/150909938/medicaid-icd-10-workarounds-in-california-three-other-states-worry

ICD-10 IMPLEMENTATION PROJECT


On April 1, 2014, the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. No. 113-93) was enacted, which said that the Secretary may not adopt ICD-10 prior to October 1, 2015. The U.S. Department of Health and Human Services has released an interim final rule that includes a new compliance date that would require the use of ICD-10 beginning October 1, 2015. The rule also requires HIPAA covered entities to continue to use ICD-9-CM through September 30, 2015. 

This page will be updated throughout the ICD-10 implementation process to ensure it contains the most up-to-date information.  Providers and submitters are encouraged to visit this page often for important updates.

FAQs


Due to the passage of HR Bill 4302 on April 1, 2014, ICD-10 cannot be adopted until October 1, 2015 (see the Federal Register below).

The International Classification of Diseases, 10th Edition consists of two parts:

  1. ICD-10 CM (Clinical Modification) for diagnosis coding
  2. ICD-10 PCS (Procedure Coding System) for inpatient procedure coding

ICD-10 CM will be used in all U.S. health care settings and uses 3 to 7 alphanumeric characters as opposed to 3 to 5 digit codes used by ICD-9 CM.  ICD-10 PCS uses 7 alphanumeric digits rather than 3 to 4 numeric digits and is more specific.

ICD-10 will affect diagnosis and inpatient procedure coding for all HIPAA covered entities including Healthcare Providers, Billing Agents/Clearinghouses, and Health Plans.  The transition to ICD-10 code sets will require business and system changes throughout the health-care industry.  All Providers that are covered by HIPAA must make the transition by the compliance date.

Reasons ICD-9 is being replaced:


  1. Produces limited data about patients’ medical conditions and inpatient hospital procedures.  ICD-10 will enhance the measurement of quality of care through the assignment of more specific codes.
  2. Outdated terms that are inconsistent with current medical treatment and technology; the number of new codes that can be created is limited and majority of the categories are full and do not reflect advanced technology and care delivery available today.  ICD-10’s granularity will enhance clinical decision-making, allow us to better track public health issues, and ensure accurate payment for services rendered.

For dates of service and dates of discharge prior to October 1, 2015, the claim must use ICD-9 codes. For dates of service and dates of discharge on or after October 1, 2015, claims must contain ICD-10 codes. Claims will be rejected if an invalid diagnosis or procedure code is submitted after the compliance date.

ICD-10 will impact your reimbursements, so it is important to start preparing for the transition to ICD-10 codes.

Federal Registers

News/Updates


Though the passage of HR4302 allows for a delay of ICD-10 compliance until October 1, 2015, the Louisiana Department of Health and Hospitals has approved the continued renovation of the Louisiana Medicaid Management Information System (LA MMIS) for ICD-10.  Gainwell Technologies and the BAYOU HEALTH plans and Magellan will continue with modifications to the LA MMIS system to meet ICD-10 compliance on October 1, 2015.  DHH encourages providers to continue the same level of intensity and support to meet the ICD-10 project objectives.

Resources


The Centers for Medicare & Medicaid (CMS) provides extensive information for providers, payers and vendors, including fact sheets, tools, timelines and resources for implementing ICD-10.

American Health Information Management Association (AHIMA)

Workgroup for Electronic Data Interchange (WEDI) provides a broad-based interactive forum for healthcare executives, managers, and advisors to utilize in addressing the business issues and policy formulation for the industry.

Other Helpful Resources:


The American Academy of Professional Coders (AAPC) provides education and professional certification to physician-based medical coders and student training, certification, ongoing education, and networking.

Centers for Disease Control (CDC) ICD-10-CM

Healthcare Information and Management Systems Society (HIMSS)

ICD-10 Monitor

WHO ICD Web Site: The World Health Organization (WHO) provides links and downloads to help better understand ICD coding and the transition from ICD-9 to ICD-10.