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ICD-10

ICD-10

Publication Date: August 26, 2015

ICD-10 Goes Into Effect on October 1, 2015.  Are You Ready?

Medicaid services providers are required to use ICD-10 (International Statistical Classification of Diseases, and Health Related Problems, 10th Edition) codes in claim transactions when the service date of the transaction is on or after October 1, 2015. All providers must transition to ICD-10 codes for electronic transactions on or before the compliance date.  Failure to do so will result in delayed payments or even non-payment.

ICD-10 is a medical classification system from the World Health Organization designed to standardize disease and health-related classifications. It replaces ICD-9 code sets that have been used to report medical diagnoses and procedures.

Information for Providers of Services

NCTracks Trading Partners: No Delay in Medicaid Implementation of ICD-10

Recent correspondence suggests that some private payers may be delaying the implementations of ICD-10. According to the North Carolina Department of Health and Human Services, the federally mandated October 1 deadline stands. There is no delay or grace period for Medicaid. Claims submitted by all providers to NCTracks with date of service or date of discharge on or after October 1 must have ICD-10 codes or they will be denied. There are no exceptions.

Please help us to convey this message to your providers so that payment for claims are not unnecessarily delayed when the Oct. 1 deadline becomes effective. Thank you for your help.

 

ICD-10 Testing

Sandhills Center is currently testing ICD-10 with our vendor. All providers and clearing houses interested in ICD-10 format testing with Sandhills are invited to contact us at edi@sandhillscenter.org/.

  • Sandhills Center will accept test 837s through August 31, 2015.
  • Limit test files to a maximum of 10 claims. Multiple test files will be accepted.
  • Providers who submit 8371 and 837P files should sent both for testing.
  • Test files will be processed within three to five business days. Notification will be sent upon test completion.
  • Sandhills has experienced issues with our FTP notifications. We are requesting test files to be submitted via secure email to edi@sandhillscenter.org/. If you are unable to send secure email, notify us and we will send you a secure email to which you can reply and submit your test file(s).

Email questions to edi@sandhillscenter.org/.

 

ICD-10 Updates

Are You Ready for ICD-10

ICD-10 Categories

ICD-10 Format

ICD-10 Resources