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IHCP reminds all providers about default ICD indicator on Web interChange

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IHCP reminds providers about default ICD indicator on Web interChange

The Indiana Health Coverage Programs (IHCP) implemented ICD-10 on October 1, 2015. As part of the implementation, Web interChange claim submission screens were  programmed to default to "ICD-10" for all claims entered on or after October 1, 2015.

Providers submitting claims via Web interChange for DOS on or before September 30, 2015, must change the indicator from "ICD-10" to "ICD-9" and use the applicable ICD-9 procedure and/or diagnosis code. Providers submitting claims via Web interChange for DOS on or after October 1, 2015, do not need to change the ICD indicator and must use the appropriate ICD-10 diagnosis code.

Claims billed with an ICD-9 indicator for DOS on or after October 1, 2015, will be denied, regardless of whether an ICD-9 diagnosis or ICD-10 diagnosis code was used in the procedure and/or diagnosis field. Conversely, claims billed with an ICD-10 indicator for DOS before October 1, 2015, will be denied, regardless of whether an ICD-9 procedure/diagnosis or ICD-10 procedure/diagnosis code was used in the diagnosis field.

For claims with DOS that span October 1, 2015, providers should refer to the IHCP Span Date Logic Tables on the ICD-10 Information page to ensure that the correct indicator and code version ‒ ICD-9 versus ICD-10 ‒ are used.