ICD-10 Quick Tips: Updated guidelines for submitting authorizations and referrals

September 22, 2015

Changes were made to the way authorizations and referrals are processed in regards to ICD-9/ICD-10 coding, as reflected in the recent NaviNet enhancements.

Please use the updated guidelines below when submitting an authorization and/or referral for services that occur on or around the October 1, 2015, ICD-10 compliance date:

  • All authorization and referral requests submitted with an anticipated/proposed date of service prior to and including September 30, 2015, are required to use ICD-9 codes.
  • All authorization and referral requests submitted with an anticipated/proposed date of service on or after October 1, 2015, are required to use ICD-10 codes.

Code set to use when requesting authorization or referral for professional, inpatient, and outpatient services

Anticipated/Proposed date of serviceCode set to use
Prior to and including September 30, 2015ICD-9
On or after October 1, 2015ICD-10