International Classification of Diseases, 10th Edition (ICD-10)

The transition to ICD-10 is necessary due to the data limitations ICD-9 produces related to patients’ conditions and hospital inpatient procedures. ICD-9 is outdated, inconsistent with current medical practice and limits the creation of new codes. ICD-10 provides an expanded set of diagnosis (ICD-10-CM) and procedure (ICD-10-PCS) codes to keep pace with medical and technological advances. In preparation for the full implementation of ICD-10 code sets on October 1, 2015, the Iowa Medicaid Enterprise (IME) encourages all providers to test ICD-10 claim submissions. Please read the section webpage on testing ICD-10 claim submission with Iowa MedicaidTo learn more about ICD-10, please read the ICD-10 Frequently Asked Questions

19 weeks until the October 1, 2015
Federal deadline for ICD-10 implementation


News and Announcements
  • Key Contact Information for the ICD-10 Group:
    1-800-338-7909 (toll-free), 515-256-4609 (if calling in Des Moines), (Email)

  • Claim Dates of Service (DOS): All ICD-10 test claims DOS must be between January 1, 2015 and the current date. The Medicaid Management Information System (MMIS) does not accept future dated claims

  • WEDI Releases News White Paper on ICD-10 Testing for Small Providers: The Workgroup for Electronic Data Interchange (WEDI) released a new white Paper, “ICD-10 Testing for Small Providers”. This white paper provides physician practices with a starting point for ICD-10 testing by focusing on primary considerations and steps for external testing with payers to ensure compliance with the October 1, 2015 implementation date. Download the white paper.

Testing ICD-10 Claim Submission with Iowa Medicaid
In preparation for ICD-10 implementation, Iowa Medicaid encourages all providers to begin testing ICD-10 claim submissions as soon as possible. Two testing options are available through Iowa Medicaid for Level 3 External Testing: End-to-End (E2E) and Business-to-Business (B2B).

Frequently Asked Questions (FAQ)
Please read the Frequenly Asked Questions document for answers to the most commonly encountered questions involving IME ICD-10. 

Iowa Medicaid ICD-10 Informational Letters
The following IME information letters have been published regarding ICD-10 implementation.

  • 1495 – ICD-10 Implementation-Centers for Medicare and Medicaid Services (CMS) Edits for ICD-10-CM Diagnosis Codes
  • 1490 – ICD-10 Testing Terms and Schedule Update
  • 1485 – ICD-10 Implementation-Claim Submission Code Set and Service Date Requirements
  • 1481 – Modification to the ICD-10 Testing Calendar
  • 1477 – ICD-10-CM Diagnosis Coding Conventions and Guidelines
  • 1472 – ICD-10 Testing of Claim Submission for Seamless Transition (January 2015)
  • 1463 – ICD-10 Testing of Claim Submission for Seamless Transition (December 2014)
  • 1462 – Diagnosis Related Group (DRG) Impact Fiscal Analysis for ICD-10 Implementation (December 2014)

Subscribe now to receive Iowa Mediciad informational letters.

Iowa Medicaid ICD-10 Provider Readiness Survey
The IME conducted and will continue to conduct periodic surveys to assess the readiness of IME providers prior to the October 1, 2015 launch date of ICD-10. Below are the results of previous surveys.

Centers for Medicare and Medicaid Services (CMS) ICD-10 Resources
CMS provides extensive information, tools and resources for implementing ICD-10. Go to the CMS "Quick Reference" webpage to find a wealth of information and resources on ICD-10.