Ohio Department of Medicaid - ICD-10 and the Claims Compliance Date
The Ohio Department of Medicaid (ODM) is receiving questions on the claims compliance date for ICD-10. The ICD-10 compliance date is October 1, 2015 (10/1/15). It is important to note that the compliance date is based on when a service is provided and not the date a claim is submitted. For outpatient and non-institutional service providers, the compliance date is based on the date of service. For institutional/inpatient service providers, the compliance date is based on the date of discharge. Because of timely filing rules, ICD-9 coded claims will continue to be accepted after the compliance date, but ONLY for claims with service(s) rendered or dates of discharge prior to the compliance date. Finally, ODM systems cannot convert between ICD-9 and ICD-10 code-sets. In other words, this means:
• a claim submitted with a date of service/date of discharge prior to 10/1/15 will adjudicate as an ICD-9 coded claim; and
• a claim submitted with a date of service/date of discharge on or after 10/1/15 will adjudicate as an ICD-10 coded claim.
This information is contained within Ohio Medicaid’s ICD-10 TIPS entitled, “Claims Compliance Date,” at: http://medicaid.ohio.gov/Portals/0/Providers/Billing/ICD10/Tips/MICD-ClaimsCompliance.pdf.
ODM also passed along the following information and reminders for ICD-10 TIPS on CMNs and PA (as well as the ICD-10 blanket rule).
ICD-10 TIPS (Billing Guidance)