Effective October 1, 2015, entities covered under the Health Insurance Portability and Accountability Act (HIPAA) are required to use the International Classification of Diseases, 10th Edition (ICD-10) code sets in standard transactions adopted under HIPAA.
All Mississippi Division of Medicaid (DOM) enrolled providers must comply. Compliance dates are firm and not subject to change, other than at the direction of the Centers for Medicare and Medicaid Services (CMS). DOM has met the Oct. 1, 2015 go-live date for ICD-10.
What does this mean for providers?
On Oct. 1, 2015, CMS implemented the ICD-10-CM (diagnosis) and ICD-10-PCS (inpatient procedures), replacing the ICD-9-CM diagnosis and procedure code set.
- ICD-10-CM diagnosis codes will be used by all providers in every health care setting.
- ICD-10-PCS procedure codes will be used only for hospital claims for inpatient hospital procedures.
Keep in Mind
- ICD-9-CM codes will not be accepted for dates of service/discharge on or after Oct. 1, 2015.
- ICD-10 codes will not be accepted for service prior to Oct. 1, 2015.
- ICD-10 Provider presentation
- ICD-10 Vendor presentation
- Frequently asked questions for ICD-10
- International Classification of Diseases, Tenth Revision (ICD-10) Centers for Medicaid and Medicare Services
- Road to 10: The Small Physician Practice’s Route to ICD-10
- The Centers for Medicare and Medicaid Services conducts successful Medicare fee-for-service ICD-10 end-to-end testing week
Provider Testing – updated Dec. 7, 2015
ICD-10 testing to finish by the end of the 2015
Effective Dec. 31, 2015 DOM will discontinue ICD-10 testing with vendors and providers. For more information regarding testing, please follow the instructions below.
Provider testing for ICD-10 started June 1, 2014 and is conducted by Xerox.
- Test files will use dates of service Oct. 1, 2015 and after. Claims prior to this date would be considered and processed as ICD-9 claims.
- Test cycles are scheduled every Thursday.
- Submit 837X12 test files to Xerox with same approved Submitted ID and means currently used for production data.
- Use “T” in the Interchange Control Header (ISA15 Usage Indicator) to indicate that the file is a TEST file. Restrict test file to have 100 claims or less.
- Responses for test claims within two to three days after processing.
- See results by processing the returned TA1, 999, 277CA & 835 X12 files with the “T” flag.
- MississippiCAN encounters submitted by coordinated care organizations will be processed within same timeline.
Web portal test link
The web portal is available for ICD-10 testing at the link below. To access the site, providers need to use production login credentials they have as of Sept. 4, 2015. Please use test web portal only for online claims entry. Batch/837 submissions will still need to use production path with appropriate ISA15 indicator ‘T’ as explained in the “Provider Testing” section above. The paper remittance advises will also be available within the same link to check status of the submitted test claims.
Vendor testing for ICD-10 started Sept. 2, 2014 and is conducted by Xerox.
- Xerox will contact your designated point person with file layout specification.
- Test files and extracts will use dates of service May 1, 2014 and after.
- The greatest anticipated impact to vendors is receipt of claims extracts.
To sign-up for provider or vendor testing email ICD10@medicaid.ms.gov.
Contact Xerox Call Center for questions regarding testing toll-free at 800-884-3222.
If you have questions regarding ICD-10, contact the Office of Medical Services by: