October 1st ICD-10 Transition

Effective October 1st, 2015, all services performed and billed to Medicaid, VA and private insurance companies will be required to have an ICD-10 diagnosis or procedural code in authorization plans and 485s in eRSP. The new ICD-10 code version replaces the current ICD-9 codes for services provided after September 30th. Authorizations and 485s both feed the 1500/UB-04 billing forms and electronic claim filing transactions.

On May 27th – 29th, to assist with this transition, eRSP will be enhanced with support for both ICD-9 and ICD-10 codes. If the start or end date of your 485 or authorization spans October 1st, 2015, you will see additional options to enter both the appropriate ICD-9 code as well as its equivalent ICD-10 code. For many of the ICD-9 codes, there will be one specific corresponding ICD-10 code, and eRSP will suggest that code to you automatically. If there are several equivalent ICD-10 codes, you will be given a reference tool to help select the correct ICD-10 version. For authorizations and 485s that start after October 1st, you will only see one field for ICD-10.

The eRSP Medicaid Claim feature will use the authorization plan and the 485 forms to include the appropriate ICD-9 or ICD-10 code based on the date of service. All you will need to do is verify the correct codes in your existing authorization plans and 485 forms.

Additionally, a new report will be available that lists all of your ICD-9 or ICD-10 codes entered on your 485 and customer authorization plans.

For more information on eRSP and ICD-10 check out our video here.

For more information on ICD-10 codes see www.cms.gov.