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ICD-10 > Frequently Asked Questions

Frequently Asked Questions (FAQs) for ICD-10

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



Category: Billing


Published: 10/16/2013


Updated: 4/15/2014


QID: I10



Institutional Claims

If the claim is for Clinic APG Episode of Care or CHHA Episodic services with multiple dates of service where the through date is on or after October 1, 2015, the claim must be coded as ICD-10 for all dates of service - even if the episode started before October 1, 2015.

For other types of Rate Based Institutional claims that do not bill using from and through dates of service, providers must split their claims to separate ICD-9 claims (prior to October 1, 2015) from ICD-10 claims (on or after October 1, 2015).

For those Institutional providers who bill the first of the month subsequent to when the service was rendered. The ICD Version used is determined by the date of service as it appears on the claim. Therefore, services rendered in September 2015 that are billed as date of service October 1, 2015, must use the ICD-10 code set.

Professional Claims

Professional claims must be split to separate ICD-9 claims (date of service prior to October 1, 2015) from ICD-10 claims (date of service on or after October 1, 2015).

All paper claim forms must conform to the same instructions set forth for electronic claims.