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ICD-10 Implementation

Welcome to the Medicaid ICD-10 webpage. Here you will find information about the Kentucky Department for Medicaid Services plans for ICD-10 implementation.

Click below to view:

Please check back frequently for updates to this page.

What's New

Notice to All Stakeholders

In light of the recent passing of House Resolution 4302, the Department of Health and Human Services (HHS) cannot adopt the ICD-10 code set as the standard until at least October 1, 2015. The Kentucky Department for Medicaid Services (DMS) and Hewlett Packard Enterprise (HP) will continue to move forward with the goal of remediating the fiscal agent system and conducting end-to-end external testing by October 1, 2014. Providers and Clearinghouses are encouraged to contact HP's EDI helpdesk if they would like to test with DMS/HP when external testing begins June 2014.

DMS will continue to post updates to this site as more information about the delay and new implementation timelines are made available.

If you have questions, you may submit them through the mailbox.

CMS Updated articles and FAQs

New Provider Letters

CMS and Medicare Learning Network now offers educational videos on healthcare related topics

(08/30/13) - MLN Connects™ National Provider Calls (MLN Connects Calls), a part of the Medicare Learning Network® (MLN), provide educational conference calls about new policies and/or changes to the Medicare program. As a result of these provider calls,a CMS YouTube Channel has been created for providers to view the catalog of educational videos available on a wide range of healthcare related topics including ICD-10.

ICD-10 articles for healthcare providers

WEDI reports disappointing findings on ICD-10 readiness to CMS

(04/11/2013) - The Workgroup for Electronic Data Interchange announced Thursday that it had submitted its ICD-10 industry readiness survey to the Centers for Medicare and Medicaid Services (CMS). Its findings continue to show insufficient readiness for the October 2014 transition deadline. Read the rest of the article or review the Letter tor CMS

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ICD-10 News: Updated Implementation Guides

CMS has released updated ICD-10 Implementation Guides for small and medium practice providers, large practice providers, small hospitals, and payers. These guides are step-by-step resources for providers and payers looking for help with their ICD-10 transition. They are available on the CMS ICD-10 page under the Provider Resources tab along with other materials for providers.

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ICD-10 Implementation Presented by CMS
Keep the Dates Nov. 15 and 16, 2012

The Cabinet for Health and Family Services, in collaboration with the Department for Medicaid Services, is hosting an on-site visit from the Centers for Medicare and Medicaid Services to discuss processes for ICD-10 implementation. This two-day webinar is open to all organizations including Medicaid service providers, trading partners, contractors, managed care organizations and other interested parties.

Please refer to the documents below for information about the training sessions. Additional information will be posted to the website as it is received.

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ICD-10 Delay Information

New ICD-10 Deadline - Oct. 1, 2014

HHS has announced the final rule that delays the ICD-10 compliance date from Oct. 1, 2013, to Oct. 1, 2014.

For more information, see the announcement or the final rule.

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Public comment period ended on May 17, 2012

View the proposed rule.

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HHS proposes one-year delay of ICD-10 compliance date

On April 17, 2012, the Department of Health and Human Services (HHS)published a proposed rule that would delay, from Oct. 1, 2013, to Oct. 1, 2014, the compliance date for the International Classification of Diseases, 10th edition diagnosis and procedure codes (ICD-10).

The ICD-10 compliance date change is part of a proposed rule that would adopt a standard for a unique health plan identifier, adopt a data element that would serve as an other entity identifier and add a national provider identifier requirement. The proposed rule was developed by the Office of e-Health Standards and Services (OESS) as part of its ongoing role, delegated by HHS, to establish standards for electronic health care transactions under the Health Insurance Portability and Accountability Act of 1996. OESS is part of the Centers for Medicare and Medicaid Services.

HHS proposes that covered entities must be in compliance with ICD-10 on Oct. 1, 2014.

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Background

In health care, coding systems are used to differentiate diagnoses and procedures in virtually all treatment settings. These codes are integrated in systems and business processes in provider organizations and health plans, as well as allied businesses. Proper coding is essential in all reimbursement and claim processes.

Currently, the U.S. Department of Health and Human Services (HHS) uses the World Health Organization's International Classification of Diseases, Ninth Edition, known as ICD-9.

As issued in a final rule from HHS on Jan. 16, 2009, ICD-10-CM (Clinical Modification - diagnoses) and ICD-10-PCS (Procedural Coding System - for inpatient procedures) will become the new coding system for delineating medical diagnoses and procedures for care management and billing purposes.

Originally slated to go into effect on Oct. 1, 2013, the date was later changed to Oct. 1, 2014. The Tenth Edition "ICD-10" will replace ICD-9 on Oct. 1, 2014.

This transition from ICD-9 to ICD-10 is a provision of the Health Insurance Portability and Accountability Act (HIPAA), as regulated by HHS and the Centers for Medicare and Medicaid Services (CMS). The change to ICD-10 does not affect Current Procedural Terminology (CPT) coding for outpatient procedures.

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A Prerequisite to ICD-10

To prepare for ICD-10, HHS also mandated that transaction standards for all electronic health care claims be upgraded to Version 5010 from Version 4010/4010A standards. Every standard - from claims to eligibility and referral authorizations - was updated to Version 5010 before the enforcement discretion period ended on June 30, 2012.

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Transitioning Is Not Optional

The federal mandate to transition to ICD-10 pertains to all HIPAA-covered entities including Providers, Payers, Vendors and their business associates. Provider claims not submitted using ICD-10 codes will be pended, denied or rejected. Payments to providers cannot be made without the proper ICD-10 coding. ICD-10 will affect all HIPAA-covered entities, not just those submitting Medicare or Medicaid claims.

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The Benefits of ICD-10

ICD-10 is vital to transforming our nation's health care system. As medical science continues to evolve, so will ICD-10, with benefits including:

  • A robust coding infrastructure that contains valuable information to help providers increase case management and care coordination effectiveness.
  • Improved quality measurements and patient safety, and the evaluation of medical processes and outcomes.
  • The capability to readily expand and capture new procedures and technologies.

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ICD-10 Resources and Publications
   

Do you have questions? Would you like to recieve updates on ICD-10?
 

If you have questions about KY Medicaid ICD-10, email the CHFS DMS ICD-10 Questions mailbox.

If you are interested in receiving e-mail notices on the KY Medicaid ICD-10, click here to add or delete subscriptions at any time.

 

Last Updated 4/14/2014
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