Providers Must use ICD-10 Diagnosis Codes Beginning Oct. 1, 2015

All providers covered by HIPAA must begin using ICD-10 diagnosis codes with dates of service October 1, 2015 and beyond.  Pursuant to HIPAA, the Centers for Medicare & Medicaid Services (CMS) has mandated the transition to ICD-10 diagnosis codes.  Consequently, ICD-10 codes are required to replace the ICD-9 codes.

Claims with dates of service on or after October 1, 2015 without ICD-10 diagnosis codes will be rejected by ASR Health Benefits.  Claims with dates of service before October 1, 2015 containing ICD-10 codes will also be rejected.  This requirement will be based on discharge date for inpatient or other facility charges.  That is, if the date of service or discharge date is on or after October 1, 2015, the claim must contain ICD-10 codes.  ASR will reject claims containing both ICD-9 and ICD-10 codes.  CPT coding for outpatient procedures and physician services will not be affected.

ASR has performed payer-provider testing to prepare for the ICD-10 transition.  We will follow the standard HIPAA validation edits to reject and return claims to providers that contain invalid ICD codes.  Further, the billing provisions in our provider contracts have been updated to reflect this change.

For more information about the transition to ICD-10, please visit the CMS Website at https://www.cms.gov/Medicare/Coding/ICD10/Index.html.  If you have questions about ASR’s transition activities, you may call ASR at (800) 968-2449.