ICD-10 Deadline, impact for IBHIS and IS claims with Date of Service October 1st, 2015 +

DMH confirmed today in the IS Reports Committee Meeting, that providers must assure their EDI claims include the new ICD-10 Diagnosis (Dx) codes, for dates of service October 1st, 2015 and going forward.

The process for DMH's Integrated System (IS) is not yet defined, more to come, therefore it is not yet clear whether providers using the IS for claims submission via Data entry (DDE) will need to do anything different before they go live to IBHIS; but EDI claims will definitely require new ICD-10 codes.

So... DMH LAC contract providers and their vendors must be ready for the Oct 1^st service date cut-off for all claims going to the IS or IBHIS electronically via EDI, or begin holding their claims with service dates of October 1, 2015 an on, until they have new codes implemented in their claims transactions.

Some things to consider:

• Do you have a schedule from your EHRS vendor as to when they will be ready with ICD-10 codes in your claims?
  
• Do you have plans to test these changes using claims testing scenarios, before October 2015?
• Do you need to plan for any provider training on these new codes, or will this be transparent to your providers?
• Will your EHRS product be able to detect services/claims delivered before Oct.1st, and after Sept 31st, and apply the right code set based on service dates?
• Do you have procedures in place for Intakes and other points in service delivery when Dx is established or changes,  to differentiate between the different ICD code sets?
• Do you need to change the Dx codes you have set-up for your clients' in their IBHIS records before your IBHIS GO-LIVE?
• Will IS DDE providers need to change their data entry procedures after Dept 31st? and be able to determine by service date, which Dx to enter?
• Do you need to HOLD your claims beginning with October service dates? what will the revenue impact be?

Hope this helps!