ICD-10 > Frequently Asked Questions

Frequently Asked Questions (FAQs) for ICD-10

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Q.

Where can I find information about ICD -10?

 

 

Category: General

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I01

 
 

A.

Visit the CMS ICD-10 web site www.cms.gov/icd10 for the latest news and resources. Providers may also wish to sign up for CMS ICD-10 Industry Email Updates.

 
 

Q.

What is the compliance deadline for ICD-10?

 

 

Category: General

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Published: 10/16/2013

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Updated: 1/16/2015

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QID: I02

 
 

Q.

What if I do not switch to ICD-10 or the ICD-10 codes submitted are invalid?

 

 

Category: General

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I03

 
 

Q.

Will the eMedNY Call Center assist with ICD-10 coding?

 

 

Category: General

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I04

 
 

Q.

Can submitters transition to ICD- 10 earlier than October 1, 2015?

 

 

Category: General

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I05

 
 

Q.

Will submitters use both ICD-9 and ICD-10 codes during the transition?

 

 

Category: General

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I06

 
 

Q.

Can ICD-9 and ICD-10 be sent on the same claim?

 

 

Category: General

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I07

 
 

Q.

Are there any changes to the 5010 format for the ICD-10?

 

 

Category: General

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Published: 10/16/2013

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Updated: 7/2/2014

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QID: I08

 
 

Q.

Does eMedNY have any kind of conversion crosswalk?

 

 

Category: General

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I09

 
 

Q.

What if a claim spans the date of service of October 1, 2015?

 

 

Category: Billing

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I10

 
 

Q.

How should a DRG Inpatient claim be coded if the admission is prior to October 1, 2015, but the patient is discharged on or after October 1, 2015?

 

 

Category: Billing

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I11

 
 

Q.

How should non-DRG Inpatient claims (ALC, Detox, etc.) be coded?

 

 

Category: Billing

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Published: 10/16/2013

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Updated: 6/11/2015

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QID: I12

 
 

Q.

How should an Inpatient claim for Psychiatric services (rate code 2852) be coded?

 

 

Category: Billing

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I13

 
 

Q.

Do pharmacy providers billing via NCPDP D.0 need to notify their software vendors to make any changes for ICD-10 Diagnosis codes?

 

 

Category: Billing

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I14

 
 

Q.

Will there be any changes to the eMedNY paper claim forms?

 

 

Category: Billing

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I15

 
 

Q.

When will the Provider Testing Environment (PTE) be available?

 

 

Category: Testing

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Published: 10/16/2013

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Updated: 12/18/2014

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QID: I16

 
 

Q.

Will eMedNY be performing ICD-10 code set validation based on the date of service?

 

 

Category: Testing

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I17

 
 

Q.

Are there any specific rejections and reason/remark codes for electronic claims that will be used to identify ICD-10 errors?

 

 

Category: Testing

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I18

 
 

Q.

Will eMedNY support end to end testing: Adjudicate the claim and send back Electronic Remittance Advice (ERA)?

 

 

Category: Testing

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I19

 
 

Q.

I use ePACES for submitting claims. How/when will I be able to test?

 

 

Category: Testing

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I20

 
 

Q.

Will eMedNY provide remittance advice?

 

 

Category: Testing

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Published: 10/16/2013

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Updated: 9/4/2014

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QID: I21

 
 

Q.

Are there limits to testing with eMedNY for ICD-10 testing?

 

 

Category: Testing

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I22

 
 

Q.

Will eMedNY require enrollment for ICD-10 testing?

 

 

Category: Testing

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I23

 
 

Q.

What will submitters need to do to prepare for testing with eMedNY?

 

 

Category: Testing

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I24

 
 

Q.

Will eMedNY allow providers that use clearinghouses to test directly and bypass the normal clearinghouse testing process?

 

 

Category: Testing

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I25

 
 

Q.

Which transaction sets should submitters test for ICD-10?

 

 

Category: Testing

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I26

 
 

Q.

When testing, what are the requirements around the date of service?

 

 

Category: Testing

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Published: 10/16/2013

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Updated: 10/2/2015

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QID: I27

 
 

Q.

How will eMedNY communicate test results?

 

 

Category: Testing

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Published: 10/16/2013

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Updated: 4/15/2014

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QID: I28

 
 

Q.

Does eMedNY require trading partners to re-enroll in order to test ICD-10?

 

 

Category: Testing

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Published: 2/21/2014

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Updated: 4/15/2014

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QID: I29

 
 

Q.

For claims which are not directly related to a diagnosis, such as Child Care, Managed Care and Waiver Services, ICD-9 code 7999 is currently used. Which code will be utilized for ICD-10?

 

 

Category: Billing

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Published: 2/21/2014

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Updated: 4/15/2014

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QID: I30

 
 

Q.

How are APG claims affected by ICD 10?

 

 

Category: Billing

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Published: 2/21/2014

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Updated: 12/18/2014

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QID: I31

 
 

Q.

Will ICD-10-PCS replace the Current Procedural Terminology (CPT)?

 

 

Category: Billing

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Published: 11/13/2014

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Updated: 11/13/2014

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QID: I32

 
 

Q.

Do dental providers need to be concerned with ICD-10 testing?

 

 

Category: Testing

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Published: 1/9/2015

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Updated: 9/4/2015

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QID: I33

 
 

Q.

Does ICD-10 pertain to private duty nurses?

 

 

Category: General

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Published: 1/9/2015

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Updated: 6/24/2015

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QID: I34

 
 

Q.

Do transportation providers need to do anything to prepare for ICD-10?

 

 

Category: General

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Published: 1/9/2015

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Updated: 1/9/2015

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QID: I35

 
 

Q.

Does ICD-10 coding apply to me?

 

 

Category: General

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Published: 1/9/2015

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Updated: 3/19/2015

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QID: I36

 
 

Q.

Do I use an actual client CIN when submitting test claims?

 

 

Category: Testing

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Published: 1/9/2015

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Updated: 1/9/2015

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QID: I37

 
 

Q.

What ICD-10 codes are used by ophthalmic services?

 

 

Category: General

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Published: 1/9/2015

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Updated: 1/9/2015

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QID: I39