ICD-10 News: Qualifiers for ICD-10 Diagnosis Codes on Electronic Claims

News Updates | February 4, 2016

Qualifiers for ICD-10 Diagnosis Codes on Electronic Claims As you submit electronic claims for services, remember that: Claims with ICD-10 diagnosis codes must use ICD-10 qualifiers; all claims for services on or after October 1, 2015, must use ICD-10 Claims with ICD-9 diagnosis codes must use ICD-9 qualifiers; only claims for services before October 1, 2015, can use ICD-9 How to Use ICD-10 Qualifiers Use ICD-10 qualifiers as follows (FAQ 12889): For ASC X12 837P 5010A1 claims, the HI01-1 field for the Code List Qualifier Code must contain the code “ABK” to indicate the principal ICD-10 diagnosis code being sent. When sending more than one diagnosis code, use the qualifier code “ABF” for the Code List Qualifier Code to indicate up to 11 additional ICD-10 diagnosis codes that are sent. For ASC X12 837I 5010A1 claims, the HI01-1 field for the Principal Diagnosis Code List Qualifier Code must contain the code “ABK” to indicate the principal ICD-10 diagnosis code being sent. When sending more than one diagnosis code, use the qualifier code “ABF” for each Other Diagnosis Code to indicate up to 24 additional ICD-10 diagnosis codes that are sent. For NCPDP D.0 claims, in the 492.WE field for the Diagnosis Code Qualifier, use the code “02” to indicate an ICD-10 diagnosis code is being sent. Keep Up to Date on ICD-10 Visit the CMS ICD-10 website and Roadto10.org for the latest news and and official resources, including the ICD-10 Quick Start Guide and a contact list for provider Medicare and Medicaid questions. Sign up for CMS ICD-10 Email Updates and follow us on Twitter.

Search the Medicare Physician Fee Schedule

The MLN Connects® Provider eNews contains important news, announcements, and updates for health care professionals. Thursday, February 4, 2016 Can't view the image? Read the eNews! View this edition as a PDF In This Edition: MLN Connects® Events New Audio Recordings and Transcripts Available Other CMS Events Medicare Quality Reporting Programs Webinar: What Eligible Providers Need to Know in 2016 Medicare Learning Network® Publications and Multimedia Prohibition on Balance Billing Dually Eligible Individuals Enrolled in the QMB Program MLN Matters® Article — Revised Implementation of Fingerprint-Based Background Checks MLN Matters Article — Revised The Medicare Home Health Benefit Web-Based Training Course — Revised Remittance Advice Information: An Overview Fact Sheet — Revised Medicare Advance Beneficiary Notices Booklet — Revised How to Use the Searchable Medicare Physician Fee Schedule Booklet — Revised Announcements CMS Announces Proposed Improvements to Medicare Shared Savings Program CMS Releases Home Health Patient Experience of Care Star Ratings New Proposal to Give Providers and Employers Access to Information to Drive Quality and Patient Care Improvement Comment Period for IMPACT Act Measures Extended to February 5 Comment Period for RFI on Reporting of Quality Measures Extended to February 16 Hospice, IRF, LTCH, SNF, HHA: QIES System Downtime from March 16 through 21 Register in Open Payments System to Review and Dispute 2015 Data 2015 PQRS Data: Submission Deadlines Applying for an EHR Hardship Exception: FAQs Temporary Moratoria Extended on Enrollment of New Home Health Agencies and Part B Ambulance Suppliers Stop Hepatitis C Virus Transmission in Patients Undergoing Hemodialysis Flu Season Begins: Severe Influenza Illness Reported February is American Heart Month Like the eNews? Have suggestions? Please let us know! The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered trademarks of the U.S. Department of Health and Human Services (HHS).

Advance Care Planning: What You Need to Know

The MLN Connects® Provider eNews contains important news, announcements, and updates for health care professionals. Thursday, March 31, 2016 Can't view the image? Read the eNews! View this edition as a PDF In This Edition: MLN Connects® Events Medicare Shared Savings Program ACO: Preparing to Apply for 2017 Call — Last Chance to Register Open Payments 2016: Prepare to Review Reported Data Call — Register Now IMPACT Act: Data Element Library Call — Register Now Medicare Shared Savings Program ACO Application Process Call — Register Now 2016 PQRS Reporting: Avoiding 2018 Negative Payment Adjustments Call — Registration Now Open National Partnership to Improve Dementia Care and QAPI Call — Registration Now Open New Video Slideshow Available Medicare Learning Network® Publications and Multimedia Basics of Medicare Series of Web-Based Training Courses — New Long-Term Care Hospital Prospective Payment System Booklet — Revised Medicare Ambulance Transports Booklet — Revised Clinical Laboratory Fee Schedule Fact Sheet — Revised Hospital Outpatient Prospective Payment System Fact Sheet — Revised Announcements CMS Launches New Effort to Improve Care for Nursing Facility Residents Advance Care Planning: New FAQs Claims, Pricers, and Codes Modifications to HCPCS Code Set Medicare Payment for PAP Devices The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered trademarks of the U.S. Department of Health and Human Services (HHS).