Get ready for the upcoming ICD-10 compliance date

July 2, 2015


With the October 1, 2015, compliance deadline for ICD-10 only three months away, Independence would like to make sure that all provider offices are taking the necessary steps to get ready for ICD-10.

Compliance deadline

Independence would like to remind providers that we will not accept ICD-9 codes on any referrals, authorizations, or claims for dates of service on or after October 1, 2015. If your office submits an ICD-9 code after the compliance date, your referral, authorization, or claim will be denied and sent back to you for proper coding. Providers should work with their trading partners, clearinghouses, and billing vendors/billing software companies to ensure ICD-10compliance and avoid claims rejections and processing delays.

Ensure successful claims payment

In order for your claims to process correctly, all providers must bill with ICD-10 codes for all dates of service on or after October 1, 2015. Any claims submitted for dates of service on or after October 1, 2015, with ICD-9 codes will be denied.

If the dates of service span the compliance date, the claim will need to be split. ICD-9 codes should be used for dates of service prior to October 1, 2015, and ICD-10 codes should be used for dates of service on or after October 1, 2015. Note: You cannot submit both ICD-9 and ICD-10 codes on a single claim.

As a reminder, all network providers are required to use the Health Insurance Portability and Accountability Act (HIPAA) 5010 electronic format and CMS-1500 (02/12) paper format in order to avoid denials.

Keeping you informed

Independence maintains a dedicated ICD-10 web page where you can find up-to-date information, including updates on external testing, frequently asked questions, and dial-in information for the monthly What?s Up Wednesday teleconference calls.

We have also published information in Partners in Health UpdateSM, including the following recent articles:

We will continue to provide ICD-10 updates in future editions of Partners in Health Update.

Additional resources

The Centers for Medicare & Medicaid Services (CMS) ICD-10 web page offers a plethora of resources for your use, including:

We encourage providers to use these resources as they prepare for ICD-10.