Although the transition to ICD-10 has been smooth, we are seeing a few common errors from our providers when submitting claims.
Here are some reminders to help you submit claims correctly:
- Qualifiers and codes must match. If you send ICD-10 codes, you must send ICD-10 qualifiers. If you send ICD-9 codes, you must send ICD-9 qualifiers.
- If the Dates of Service on the claim are prior to October 1, 2015, you cannot send an ICD-10 coded claim.
- Outpatient and Professional Claims will generally need to be split, with Dates of Service prior to Allowed Date as ICD-9, and Dates of Service on or after Enforcement Date as ICD-10. See CMS split guidelines.
- ICD-10 codes must be submitted with the required number of digits.
Action Required: Follow the guidelines above.