Implementation of ICD-10 is two weeks away. Lindy Lady, medical business manager for the Kentucky Medical Association, offers some reminders for what physicians’ staffs will need to remember when processing claims:
- All claims with dates of service of Oct. 1, 2015, or later must be submitted with a valid ICD-10 code; ICD-9 codes will no longer be accepted for these dates of service.
- Kentucky Medicaid is required to process submitted claims that include ICD-10 codes for services furnished on or after Oct. 1, 2015, this includes dual-eligible (Medicare primary, Medicaid secondary).
- All insurers except Medicare expect claims for dates of service Oct. 1, 2015, and after to list ICD-10 codes that are coded to the highest level of specificity*.
- *Medicare only — While diagnosis coding to the correct level of specificity is the goal for all claims, for 12 months after ICD-10 implementation, if a valid ICD-10 code from the right family is submitted, Medicare will process AND not audit valid ICD-10 codes unless such codes fall under a National Coverage Determination (NCD) or Local Coverage Determination (LCD) where ICD-10 to the highest level of specificity is required for payment.
- Medicaid only — If claims are rejected and the ICD-10 code is correct, or some other issue occurs with electronic claim submission relating to the ICD-10, use this portal for Medicaid claims:KY_EDI_Helpdesk@hp.com or KY_EDI_Group@hp.com
Contact KMA at Lady@kyma.org to report ICD-10 payer problems or for assistance with ICD-10 code selection.
[small][well]News article reposted from the Kentucky Medical Association page[/well][/small]
