Medical Billing Forum
Billing => Billing => : Marcus2013 June 27, 2013, 06:15:24 AM
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CMS has released three new FAQs about submitting ICD-10 claims around the October 1, 2014, deadline. These FAQs about submitting claims and explain how to split claims for services that span the October 1, 2014, transition date.
QUESTION 1.How do I report ICD-10 codes on claims when the dates of service span from prior to 10/1/2014 to on or after 10/1/2014?
ANSWER: Many payers are requiring claims with dates of service that span the October 1, 2014 implementation date to be split so that the services prior to 10/1/2014 are billed separately and utilize ICD-9 codes; services on and after 10/1/2014 are billed separately and utilize ICD-10 codes. Check specific payer guidelines for processing claims for services that span the 10/1/2014 ICD-10 transition date.
QUESTION 2.If I submit or process a transaction with an ICD-9 code for a date of service after October 1, 2014, am I HIPAA compliant?
ANSWER: The date of service determines the compliant code format to be used in a claim regardless of the date the claim is filed or submitted. Providers will submit claims after October 1, 2014 with ICD-9 codes when the services were performed prior to October 1, 2014. Payers will process claims if received after October 1, 2014 with ICD-9 codes when the services were performed prior to October 1, 2014. This situation is HIPAA compliant.
QUESTION 3:How long after the October 1, 2014 ICD-10 compliance date must I continue to report and/or process ICD-9 codes?
ANSWERl:Each payer determines their late filing requirements for standard transactions and ICD-10 does not require a change to these requirements. These deadline requirements vary among plans. Contact your payer for the current information regarding late filing for claims.