ICD-10 became effective October 1, 2015. Has your provider agency implemented it?

Without ICD-10 providers will experience delayed payments or even non-payment and a possible increase in rejected, denied or pended claims. Be reminded that when dates of service span the October 1 deadline for ICD-10, you will need to split the claim in most cases, with the exception of hospital inpatient claims. A split claim is really two separate claims. You will submit an ICD-9 claim with dates of service before October 1 and an ICD-10 claim for dates of service on and after October 1.

If you have not implemented ICD-10 or are having problems, you may refer to the resource materials referenced below or contact the Alliance Provider Helpdesk at (919) 651-8500.

What is ICD-10?

ICD-10 (International Statistical Classification of Diseases, and Health Related Problems, 10th Edition) is a medical classification list by the World Health Organization. It is designed to be a central, or core, classification for a family of disease and health-related classifications. The ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets.

ICD-10 Quick Reference Sheet (good for posting in your agency or sharing among staff)

Creating SARs in Alpha with ICD-10 Diagnoses

How can I learn more about ICD-10?

This is a listing of ICD-10 web resources and training vendors. There are many organizations offering ICD-10 information, educational resources and checklists.

The following presentation was used as part of Alliance’s ICD-10 training held May 11:

Are You Ready for ICD-10?

From the Centers for Medicare and Medicaid Services:

Official CMS Industry Resources for the ICD-10 Transition

ICD-10 Provider Resources

From the World Health Organization:

ICD-10 Classification of Mental and Behavioral Disorders

From NCTracks:

NC Tracks ICD10 Resources for Healthcare Providers

NCTracks ICD9-ICD10 Crosswalk (using this resource you can connect the old ICD-9 codes to the new ICD-10 codes)

Additional ICD-10 Trainings in September

From SAMHSA:

Transition to ICD-10: What it Entails and Why it’s Important to Behavioral Health Providers

DSM-5 (DSM-5 diagnosing for authorizations went into effect August 1, 2014)

DSM-IV to DSM-5 Guidance and ICD-9 Crosswalk



Page last modified: December 31, 2015