8/22/16: ICD-10 Code Updates
2/26/16: ICD-10 Next Steps Toolkit
12/9/15: ICMS ICD-10 Website Wheel (interactive)
11/10/15: ICD-10 Updates from CT DSS
10/20/15: Checking Your Medicare FFS Claim Status
9/22/15: CMS has released updated “Clarifying Questions and Answers Related to the July 6, 2015 CMS/AMA Joint Announcement and Guidance Regarding ICD-10 Flexibilities,” with revised answers to Questions 1 and 9, plus nine new Q&A.
CSMS Affinity Partner Webster Bank has a variety of support services for your practice as you transition to ICD-10.
ICD-10 Transition – Payors
The recent CMS/AMA announcement of a one-year accommodation period for providers transitioning to ICD-10 was welcome news, but many physicians are wondering whether similar accommodations will be offered by private insurance companies and Medicaid.
CSMS has contacted Connecticut insurance carriers and Connecticut state agencies for ICD-10 clarification. Additional ICD-10 guidance from Connecticut insurers will be posted as it is provided.
Aetna will accept precertification requests with ICD-10 codes beginning 8/10/15. This is for services scheduled for dates that are on or after 10/1/15.
Use ICD-9 codes for precertification requests until 10/1/15 for dates of service prior to, and after 10/1/15. You don’t have to re-submit precertification requests with a new code. They will match the original precertification to the corresponding claim.
Beginning 10/1/15, Aetna will only accept ICD-10 codes for precertification.
For additional information, please visit https://www.aetna.com/health-care-professionals/icd-10-5010-npi-information.html.
Anthem has provided this ICD-10 Update page.
Cigna has provided this ICD-10 Status Report.
ConnectiCare has provided this ICD-10 FAQ sheet.
CT DSS has issued several ICD-10 provider bulletins, including PB 15-47 (ICD-10 Related EOB Codes in CT Medical Assistance Program), PB 15-61 (Claims Processing Guidance for ICD-10 Codes), and PB-14-63 (Provider Electronic Solutions (PES) Software Upgrade, Version 3.81).
CT DSS has also updated references to specific diagnosis codes related to Policy in the Fee Schedule Instructions. Visit the Provider Fee Schedule Download page on the DSS website, then scroll down and click the I accept button. The Fee Schedule Instructions are available at the top of the next page. For the latest ICD-10 information from CMAP, please refer to the CT DSS ICD-10 Implementation Information Important Message. One featured resource is the AAPC ICD-10 Code Translator, based on the CMS General Equivalency Mapping (GEM) files. Providers can map the expansion of codes by using this tool.
If you have questions about the ICD-10 implementation in CMAP, please submit your questions to firstname.lastname@example.org.
CT Workers’ Compensation Commission (WCC)
The CT Workers’ Compensation Commission will follow CMS guidelines for a one-year accommodation period.
Harvard Pilgrim Health Care
Under federal law, the ICD-10 code set will replace ICD-9 code as of October 1, 2015. We’re ready to comply with this mandate. Please note that we can’t accept or process any claims with ICD-9 codes after October 1, 2015. Claims submitted with dates of service (outpatient) or dates of discharge (inpatient) on or after October 1, 2015 must have ICD-10 codes. (From the May 2015 HealthyCT Provider Newsletter)
UnitedHealth Group intends to be in alignment with CMS and federal regulations regarding ICD-10.
As such, they will be rejecting non-compliant claims at their front door (Optum Clearinghouse) with the appropriate HIPAA rejection transaction response. This will be the case for claims coded in ICD-9 with a date of service on or after 10/1/2015, as well as for ICD-10 coded claims with a date of service prior to 10/1/2015.
Compliant claims will have transactions coded with the correct code set based on date of service or date of discharge, and they must be valid codes. CMS was very specific in that communication that valid codes will still be required.