Common ICD-10 Error - ICD Qualifier on 837 Transactions

Provider and Trading Partner testing for ICD-10 has revealed a common error that could be a stumbling block this fall. Beginning October 1, 2015, every 837 transaction submitted to NCTracks must include one or more ICD qualifiers that indicate whether the claim is using ICD-9 or ICD-10 codes.

A single claim may include either ICD-9 codes or ICD-10 codes, depending on the dates of service, but not both. An 837 transaction may include both ICD-9 and ICD-10 claims.

Errors observed in testing include:

- Claims did not contain any ICD qualifier
- Claims contained an ICD-9 qualifier with a date of service after October 1 (or vice versa)

Claims with a missing or incorrect ICD qualifier will be denied with EOB 02671 - ICD VERSION INVALID FOR DATE OF SERVICE.

An X12 List of ICD Qualifiers has been posted to the Quick Links section of the Trading Partner Information page on the NCTracks Provider Portal at the link below. This list includes information to correctly populate the ICD Version on each type of claim in an X12 837 transaction as referenced in the Technical Report Type 3 (TR3).

Anyone who submits X12 837 transactions to NCTracks is encouraged to review the list in preparation for the upcoming implementation of ICD-10.