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ODM Survey Shows Providers Lag in ICD-10 Testing Ahead of Transition

The Ohio Department of Medicaid (ODM) would appreciate your assistance by providing the information below to your members, if applicable. 

A survey was released indicating that some providers are not ready for the transition to ICD-10 (see below). ODM would like to emphasize that all Medicaid providers using ICD-9 on a claim today will be required to use ICD-10 on a claim starting 10/1/15. There is no transition period; 10/1/15 is a hard date for compliance. The compliance date is based on: date of service for outpatient and professional services and date of discharge for inpatient hospital services. If your organization typically bills span dates and your span crosses the 10/1/15 compliance date, break the claim into two claims: one claim through September 30, 2015, and another claim from October 1, 2015 to last date of span. Paid claims that need adjusted will follow the same compliance date guidelines. If the claim is originally filed with the date of service/discharge prior to 10/1/15, ICD-9 will be required. If the claim is originally filed with the date of service/discharge on or after 10/1/15, ICD-10 will be required. Prior authorization requests that will span the 10/1/2015 compliance date will accept ICD-10 codes prior to 10/1/2015.  ICD-9 codes will continue to be used on claims with dates of service/discharge prior to 10/1/15. Claims that do not use the ICD-10 codes for dates of service/discharge on or after 10/1/2015 will deny. Please prepare your organization for the transition to ICD-10 now.

If your organization is interested in testing with Ohio Medicaid, please contact our ICD-10 testing team at: Testing information for trading partners is available in the Updates section of Ohio Medicaid’s ICD-10 webpage at: If your organization submits claims directly to ODM’s MITS web portal, please be sure to select the appropriate ICD version indicator (ICD-9 or 10).

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