Provider Notice issued 06/17/15

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

This Notice reminds providers that the federally-mandated conversion from ICD-9 to ICD-10 codes must be implemented no later than 10/01/2015.  The Notice dated 03/17/2015 explained the need for facilities to update the ICD-9 code to ICD-10 code during the three month time period ending with the 10/01/2015 deadline.

Facilities currently provide ICD-9 codes only when submitting a resident’s admission information electronically to the Department of Human Services through the Medicaid Electronic Data Interchange (MEDI) or EDI vendors (formerly referred to as REV).  

ICD-10 codes have been expanded to seven characters and provide a more specific diagnosis than ICD-9 codes.  ICD-10 codes must be obtained from the resident’s physician or clinician and entered before 10/01/2015. 

All facilities are required to use MEDI to update the ICD-9 codes to the new ICD-10 codes for those residents whose admissions have already been approved and processed by the Department of Human Services.  Even if your facility uses one of the two EDI vendors this conversion requires registration with MEDI for this one-time conversion action.  Once all current resident ICD-9 codes have been updated to ICD-10 codes no additional action will be required as part of this conversion.

Registration with MEDI is performed by using the links provided under the “New Users” heading.  If your facility encounters difficulty in the registration process you may contact the Central Management Services MEDI Help Desk at 1-800-366-8768 option 1, option 3 for assistance.

Once registered with MEDI the facility should go to the Long Term Care (LTC) section where they will find a link under a heading titled “ICD-10 Update Information”.  This links to a new page to allow this one-time ICD-9 to ICD-10 code conversion for those residents whose admission has already been processed.

Once all fields on this page have been completed, select the “Submit” button.  If the transaction is successful, a Confirmation Screen will appear with a Status message of:

 “A ICD-10 Updated Successfully”. 

If a screen appears with an Error message, the number and message given will identify the reason for the error.  Those error codes are listed below.

001 = Recipient name not entered

002 = Recipient number not entered

003 = Recipient number not numeric

004 = Recipient name not found, invalid

005 = Recipient number not entered

006 = Provider number not entered

007 = Provider number invalid, not found

008 = Admit date invalid, or invalid format (CCYYMMDD)

009 = Bad recipient/provider combination (provider not found on recipient’s data)

010 = ICD-10 code invalid, not found

For new admissions submitted during the time period 07/01/2015 through 09/30/2015 both the ICD-9 and ICD-10 codes must be entered.  There will be two fields, titled

“ICD-9” and “ICD-10”, during this three month transition period.

For residents with an admission date of 10/01/2015 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 in advance of this process 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.

Felicia F. Norwood, Director

Healthcare and Family Services