The International Classification of Diseases, 10th Revision (ICD-10) medical coding system is mandated for use by the US Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS). The new codes include enhanced specificity and level of detail, and the transition to the new codes will impact health care providers and trading partners.
The enactment of the Protecting Access to Medicare Act of 2014 included a provision in the statute that ICD-10 will not be adopted as the standard code set until October 1, 2015. CMS is examining the implications of the provision and will provide guidance soon.
RI Medicaid will continue to provide education and support for preparation and will communicate updates to providers through the monthly Provider Update and this website. Providers should continue to move forward in their preparation for ICD-10. Updates will be posted as they become available.
Provider and Vendor Readiness Information
- Assess staff training needs for the ICD-10 transition.
- Understand the ICD-10 code sets and begin developing a plan for how your facility will utilize the new codes.
- Review frequently used ICD-9 codes and crosswalk to ICD-10 codes.
- Use the resources on the website and visit often to check for updates.
ICD-10 Teleconference Training
HP and RI Medicaid conducted training sessions on ICD-10 in March and April. The training offered providers and vendors information and guidance to help prepare for implementation.
To view the presentation slides, select the link below:
ICD-10 Presentation Slides
Provider and Vendor Communications
ICD-10 updates are included in our monthly Provider Update. Broadcast emails are also sent to the distribution list. In some cases, provider specific emails will be sent to Medicaid providers who provide a specific service.
RI Medicaid will provide links to valuable resources that support providers in the transition to ICD-10.
Claims and Claims Processing
This section highlights changes to claims and claims processing related to the ICD-10 transition.
Provider Electronic Solutions (PES) Software
The PES software has been modified to accommodate ICD-10 codes and now contains a qualifier to indicate if an ICD-9 or ICD-10 code is being submitted.
A testing schedule is being developed for April. If you are interested in testing, please contact your provider representative.