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Archived ICD-10 Transition Information

Welcome to the Medicaid ICD-10 Web page. Here you will find information about the Kentucky Department for Medicaid Services plans for ICD-10 implementation.

On Oct. 1, 2013, medical coding in U.S. health care settings will change from ICD-9 code sets to ICD-10 code sets. Remember if you are not ready, your claims will not be paid. Preparing now will help you avoid reimbursement issues.

Archived Announcements

WEDI reports disappointing findings on ICD-10 readiness to CMS

April 11, 2013 - The Workgroup for Electronic Data Interchange announced Thursday it had submitted its ICD-10 industry readiness survey to the Centers for Medicare and Medicaid Services. Its findings continue to show insufficient readiness for the October 2014 transition deadline. Read the rest of the article or review the Letter tor CMS.

ICD-10 Implementation Presented by CMS
Keep the Dates Nov. 15 and 16, 2012

The Cabinet for Health and Family Services, in collaboration with the Department for Medicaid Services, is hosting an on-site visit from the Centers for Medicare and Medicaid Services to discuss processes for ICD-10 implementation. This two-day webinar is open to all organizations including Medicaid service providers, trading partners, contractors, managed care organizations and other interested parties.

Please refer to the documents below for information about the training sessions. Additional information will be posted to the website as it is received.

ICD-10 Delay Information

New ICD-10 Deadline - Oct. 1, 2014

HHS has announced the final rule that delays the ICD-10 compliance date from Oct. 1, 2013, to Oct. 1, 2014.

For more information, see the announcement or the final rule.

Public comment period ended on May 17, 2012

View the proposed rule.

HHS proposes one-year delay of ICD-10 compliance date

On April 17, 2012, the Department of Health and Human Services published a proposed rule that would delay from Oct. 1, 2013, to Oct. 1, 2014 the compliance date for the International Classification of Diseases, 10th edition diagnosis and procedure codes (ICD-10).

The ICD-10 compliance date change is part of a proposed rule that would adopt a standard for a unique health plan identifier, adopt a data element that would serve as an other entity identifier and add a national provider identifier requirement. The proposed rule was developed by the Office of e-Health Standards and Services (OESS) as part of its ongoing role, delegated by HHS, to establish standards for electronic health care transactions under the Health Insurance Portability and Accountability Act of 1996. OESS is part of the Centers for Medicare and Medicaid Services.

HHS proposes that covered entities must be in compliance with ICD-10 on Oct. 1, 2014.

A Prerequisite to ICD-10

To prepare for ICD-10, HHS also mandated that transaction standards for all electronic health care claims be upgraded to Version 5010 from Version 4010/4010A standards. Every standard - from claims to eligibility and referral authorizations - was updated to Version 5010 before the enforcement discretion period ended on June 30, 2012.

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Why transition to ICD-10?

The transition to ICD-10 is occurring because ICD-9 produces limited data about patients' medical conditions and hospital inpatient procedures. ICD-9 is 30 years old, has outdated terms, and is inconsistent with current and evolving medical practice. Also, the structure of ICD-9 limits the number of new codes that can be created, and many ICD-9 categories are full.

This transition will require business and systems changes throughout the health care industry. To accommodate the ICD-10 code structure, the transaction standards used for electronic health care claims, Version 4010/4010A, must be upgraded to Version 5010 by Jan. 1, 2012.

The change to ICD-10 does not affect CPT coding for outpatient procedures.

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What is ICD-10?

The ICD-10-CM/PCS (International Classification of Diseases, 10th Edition, Clinical Modification/Procedure Coding System) consists of two parts ICD-10-CM and ICD-10-PCS.

  • ICD-10-CM is for use in all U.S. health care settings. Diagnosis coding under ICD-10-CM uses 3 to 7 digits instead of the 3 to 5 digits used with ICD-9-CM, but the format of the code sets is similar.
  • ICD-10-PCS is for use in U.S. inpatient hospital settings only. ICD-10-PCS uses 7 alphanumeric digits instead of the 3 or 4 numeric digits used under ICD-9-CM procedure coding. Coding under ICD-10-PCS is much more specific and substantially different from ICD-9-CM procedure coding.

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Are there imporant dates to remember?

Jan. 1, 2012

  • HIPAA transaction Version 4010/4010A must be upgraded to Version 5010

Oct. 1, 2013

  • Medical coding in U.S. health care settings will change from ICD-9 code sets to ICD-10 code sets.
  • ICD-10 diagnosis and procedure codes are required to be submitted effective dates of service 10/1/13 or after.
  • Inpatient claims with a discharge date on or after 10/01/2013 must be submitted with ICD-10 diagnosis and procedure codes.
  • ICD-9 diagnosis and procedure codes will be required on claims received after 10/1/13 containing dates of service or date of discharge 9/30/13 and before.
  • Claims submitted with ICD-9 codes for services provided on or after 10/01/2013 will not be processed.

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Who will need to transition

ICD-10 will affect diagnosis and inpatient procedure coding for everyone covered by the Health Insurance Portability and Accountability Act (HIPAA), not just those who submit Medicare or Medicaid claims. The following must be prepared to comply with ICD-10 transitions.

  • Kentucky Medicaid providers
  • Clearinghouses
  • Billing services
  • Software Vendors

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How do I prepare the ICD-10 transition?

It is important to start preparing now for the ICD-10 transition. Here are steps you can take to get started:

KY Medicaid Providers

  • Develop an implementation strategy that includes an assessment of the impact on your organization, a detailed timeline, training, and budget. Check with your billing service, clearinghouse, or practice management software vendor about their compliance plans.
  • Providers who handle billing and software development internally should plan for medical records/coding, clinical, IT, and finance staff to coordinate on ICD-10 transition efforts.

Software vendors, clearinghouses, and billing services

  • Have products and services in development that will allow KY Medicaid providers to fully test and implement ICD-10 code sets prior to October 1, 2015.
  • Talk to your customers now about preparing for the transition. Your products and services will be obsolete if you do not take steps now to get ready.

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Additional Resources
  KY ICD-10 Implementation page  

Articles, Letters, Publications and Trainings
 

Articles

ICD-10 Articles

Codes

Letters

Publications

Surveys

June 2011

The KY Medicaid ICD-10 Survey was conducted from May 15, 2011 to June 18, 2011. The survey was open for a month and consisted of 8 questions. All Provider types were invited to participate in the survey. Thanks again to the 230 providers, or their designees, who participated in the survey.

View the survey Results.

Training

 

Do you have questions?
 

If you have questions, email the CHFS DMS ICD-10 Questions mailbox.

 

Last Updated 5/6/2014
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