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Elizabeth M. Whitehorn, Director

Provider Notice issued 03/17/15

Conversion from International Classifications of Disease (ICD)-9 to ICD-10

​To: All Long Term Care Facilities (NFs, ICF/DDs, SMHRFs) and
Supportive Living Providers (SLPs)​
​Date: ​March 17, 2015
​Re: Conversion from International Classifications of Disease (ICD)-9 to ICD-10​

This Notice informs providers that the federally-mandated conversion from ICD-9 to ICD-10 codes must be implemented no later than 10/1/2015. Federal Centers for Medicare and Medicaid Services had previously delayed the deadline for implementation from 10/1/2014 to 10/1/2015.

Facilities currently provide ICD-9 codes only when submitting a resident’s admission information electronically submitted to the Department of Human Services through the Medicaid Electronic Data Interchange (MEDI) or EDI vendors (formerly referred to as REV). ICD-9 coding is not used to set LTC facility reimbursement rates although it is a required data element that must be provided as part of the admission information.

ICD-10 codes have been expanded to seven characters and provide a more specific diagnosis than the ICD-9 code and is provided by the resident’s physician or clinician.

  • Prior to October 1, 2015, facilities must obtain an ICD-10 code for each resident from their physician or clinician and enter the new code using the MEDI system.

  • Those facilities using Electronic Data Interchange vendors (formerly referred to as REV) cannot enter the ICD-10 codes for their current residents using that access but must register in MEDI for this one-time conversion.

  • The ICD-10 code must be entered during the time period 7/1/2015 through 9/30/2015 for all residents with an active admission on the HFS payment system at that time.

Facilities that are processing new admissions during the 7/1/2015 through 9/30/2015 period should use the ICD-10 code to ensure all residents have the new codes entered on 10/1/2015.

For residents with an admission date of 10/1/2015 or later, the ICD-10 code must be submitted as part of the regular admission transaction processed electronically. The facility may use either MEDI or EDI vendor access for these new admissions.

Facilities are being informed of this now to ensure they have adequate time to obtain the ICD-10 code from the physician or clinician, register for MEDI if not currently being used, and electronically enter updated ICD-10 codes for current residents through the MEDI system.

Questions regarding this Notice may be directed to the Bureau of Long Term Care at 217-782-0545.

James M. Parker, Acting Administrator

Division of Medical Programs