ICD-10 Q&As

Q: How will the voided claims work after October 1 if the original date of service is before implementation?

 

A: No matter when the claim is submitted, which code to use is based on date of service. Services provided before October 1 require ICD-9 codes even if the claim is submitted after October 1.

 

Q: Will the codes automatically convert from ICD-9 to ICD-10 when I submit the professional claims?

 

A: No, it won’t automatically convert. You must pick the most accurate code. See what your most used ICD-9 codes correspond to in ICD-10 using the NCTracks ICD-10 Crosswalk at http://ncmmis.ncdhhs.gov/icdxwalk.asp.

 

Q: If we have an existing prior approval, and need to submit the claim, can we use the existing prior approval or must we create a brand new one with ICD-10 codes?

 

A: If you already have an approved prior approval request with ICD-9 codes, you do not need a new prior approval with ICD-10 codes to submit the claim.

 

Q: Where can I find out more information about using the proper ICD qualifier?

 

A: Look under the Quick Links section on the right side of the Trading Partner webpage: https://www.nctracks.nc.gov/content/public/providers/provider-trading-partners.html.

 

Q: Do we have to key all the fields in brand new for the ICD-10 claims or can we just change certain fields in the batch files?

 

A: For most providers, the only claim fields that are changing with the implementation of ICD-10 are diagnosis codes. Claims for inpatient hospital charges will also use ICD-10 procedure codes.

 

Q: How will the crossover claims work?

 

A: Crossover claims will work the same way they do today. All health care claims are affected by the implementation of ICD-10, based on the date of service (or date of discharge for inpatient hospital claims.)