Insurance News:

Attention Paper Claim Submitters: Changes due to the implementation of ICD-10

by Centers for Medicare and Medicaid Services | 10/14/2015 1:27:24 PM

With the implementation of ICD 10 on October 1, 2015, it is important to use the appropriate ICD Indicators on claim submissions.

The "ICD Indicator" identifies the ICD code set being reported. It is imperative that you enter the applicable ICD indicator according to the following:

Indicator Code Set

  • 9 -- ICD-9-CM Diagnosis 
  • 0 -- ICD-10-CM Diagnosis

Dates of service October 1, 2015 and after, the ICD-10-CM indicator should be "0" Dates of service September 30, 2015 and prior, the ICD-9-CM indicator should be "9"

Line item 21 on the CMS 1500 claim form or the electronic equivalent shall be submitted with the appropriate indicator of "0" for ICD-10-CM or "9" for ICD-9-CM.

Line item 21 on the CMS 1500 claim form

Note: It is mandatory that you enter the indicator as a single digit between the vertical, dotted lines.

For additional information on ICD-10, visit our ICD-10-CM section of our website at www.ngsmedicare.com.

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