ICD-10 Q&A

The following are answers to questions sent by providers to the ICD-10 Inbox:

Q: When you speak of hospital inpatient claims being an exception to the rule of using split claims over the October 1 transition to ICD-10, does this exception apply to inpatient physician charges as well or just the hospital charges?

 

The exception to split claims only applies to the hospital charges, not physician charges. During the transition from ICD-9 to ICD-10 over October 1, hospital claims will be based on date of discharge, while physician/professional claims will be based on date of service, which means they must be split.

 

Q: I’m sure I was told that dentists would not be required to use ICD-10 codes. Am I correct about that?  

 

You’re correct in most cases. Most dental practices don’t have to worry about ICD-10. For the exceptions, see this brief article: https://www.nctracks.nc.gov/content/public/providers/ICD10/ICD10-announcements/Dental-Practices-and-ICD-10.html

 

Q: You mentioned an additional ICD-10 testing tool that might be available this summer. I haven’t seen anything about it since then. Is it available at this time?


No, the testing product didn’t work well for North Carolina. At this point, there aren’t plans for more testing beyond the provider/trading partner testing currently underway.

 

Q: I am a billing agent for a dozen family care homes. Do my clients need to have their residents see a physician between now and October to provide the new ICD-10 code, or can we adjust the number accordingly per the original diagnosis?

 

No, the residents don't need to see a physician to get their new codes. See what their ICD-9 codes correspond to in ICD-10 codes using the NCTracks ICD-10 Crosswalk at http://ncmmis.ncdhhs.gov/icdxwalk.asp You may find that there's a one-to-one match or that you can determine what the correct ICD-10 code would be for that resident. And if you can't, then you can call the physician's office and get their input.

 

Find your ICD-10 codes on the NCTracks ICD-10 Crosswalk at http://ncmmis.ncdhhs.gov/icdxwalk.asp, Send your questions about the transition to ICD-10 codes in NCTracks to NCTracks-Questioner@dhhs.nc.gov. We will share frequently asked questions with all.