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 for inpatient and outpatient
claims. For dates of discharge (inpatient) or service (outpatient) on
or before September 30, 2015, you must bill with ICD-9 codes. For dates of
discharge (inpatient) or service (outpatient) on or after October 1, 2015, you
must bill with ICD-10 codes.
- Code DME and home infusion claims appropriately. 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.