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 ICD-9 is outdated, inconsistent with current medical practice and limits the creation of new codes.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


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

 

News and Announcements
  • ICD-10 Provider Readiness Survey: The IME is conducting the fifth in a series of ICD-10 tracking surveys to determine if providers are impacted by the change to the ICD-10 code sets and to gauge the progress toward readiness for implementation. The survey must be completed by 12:00 pm (US Central Time), August 3, 2015. Please read Informational Letter 1523 for more information. You may also go directly to the survey, complete it, and send to the IME electronically before the deadline.

  • Key Contact Information for the ICD-10 Group:
    1-800-338-7909 (toll-free), 515-256-4609 (if calling in Des Moines), icd-10project@dhs.state.ia.us (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.

  • 1527 - Additional ICD-10 Testing Opportunities
  • 1526 - ICD-10 Diagnosis Code Z76.89 Replaces ICD-9 Diagnosis Code V00.01
  • 1524 - Processing of Emergency ICD-10 Diagnosis Codes
  • 1523 – ICD-10 Provider Readiness Survey
  • 1521 – Clarification on Billing the Ventilator Rate
  • 1520 – Countdown to the October 1, 2015, ICD-10 Implementation Date
  • 1519 – Clarification of Processing of Pregnancy ICD-10 Diagnosis Codes
  • 1514 – ICD-10 Diagnosis Crosswalk
  • 1513 – ICD-10 Diagnosis Code Z76.89 Replaces ICD-9 Waiver Diagnosis Code V00.01
  • 1510 – ICD-10 Implementation – Clarification of Procedure Classification System (PCS) Code Structure and Reimbursement   
  • 1504 – ICD-10 Implementation – Procedure Classification Systems Code Structure and Reimbursement   
  • 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)

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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.