NGHP Mandatory Insurer Reporting Reminder: ICD-10-CM Diagnosis Codes Coming Soon, 10/01/15

CMS, Medicare Set-Aside Blog, MEDVAL News on January 29, 2015 | Posted by Jessica M. Wingenroth, JD

In a Technical Alert dated January 28, 2015, CMS issued a reminder that October 1, 2015 is the date to remember for reporting ICD-10-CM diagnosis codes, but for most RREs, testing can be completed now.

Prior to October 1, 2015, RREs are encouraged to submit test files with ICD-10-CM diagnosis codes, but for actual reporting, the use of ICD-9-CM codes continues to be mandatory. Note that testing is not available for DDE submitters.

As of October 1, 2015, ICD-10-CM diagnosis codes are required for reports with a CMS date of injury on or after October 1, 2015. For add or update records with a CMS date of injury prior to October 1, 2015, the RRE has the option of using either ICD-9-CM codes or ICD-10-CM codes, but may not combine them in the same record. When an RRE submits an update there is no requirement to convert ICD-9-CM codes that were previously submitted to and accepted by CMS.

Additional technical details for reporting may be found on the Alert or the MMSEA Section 111 NGHP User Guide, Chapter IV, Section 6.2.5