[
Since the ICD-10 compliance date on October 1, 2015, Independence has
noticed a number of common ICD coding errors that are affecting claims
processing. Please follow the tips below to ensure that your claims are coded
correctly:
- Do not bill ICD-9 and ICD-10 codes on the same claim. Per guidelines
from the Centers for Medicare & Medicaid Services (CMS), you cannot bill
with both ICD-9 and ICD-10 codes on a single claim unless otherwise
specified.
- Use the appropriate ICD code:
- – Outpatient claims. For dates of service on or
before September 30, 2015, you must bill with ICD-9 codes. For dates of
service on or after October 1, 2015, you must bill with ICD-10
codes.
- – Inpatient claims. For dates of discharge on or
before September 30, 2015, you must bill with ICD-9 codes. For dates of
discharge on or after October 1, 2015, you must bill with ICD-10
codes.
- DME and home infusion claims. Durable medical equipment (DME) and
home infusion claims should be coded based on the "From" date or initial date
of service. If the "From" date is on or before September 30, 2015, you
must bill with ICD-9 codes. If the "From" date is on or after October 1,
2015, you must bill with ICD-10 codes.
- Use the appropriate diagnosis qualifier:
- – Paper claims. When billing with ICD-9 codes, you
must use the qualifier "9". When billing with ICD-10 codes, you must use the
qualifier "0" (CMS-1500, box 21; UB-04, field 66).
- – Electronic claims. Please refer to the most recent
version of the HIPAA-mandated 5010 ASC X12 Implementation Guides for the 837I
and 837P transactions.
- Use valid codes. Whether you are billing with ICD-9 or ICD-10 codes,
please ensure that the codes you are using are valid and appropriate.
For more information, visit our dedicated
ICD-10 web page, which includes Frequently Asked
Questions.]