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Delays in ICD-10 code processing for Medicaid programs in four states

By: Nextech | September 16th, 2015

Delays in ICD-10 code processing for Medicaid programs in four states Blog Feature

Medical practices are gearing up for the ICD-10 transition away from ICD-9 codes, set to take place in just two weeks on October 1. However, four states in the U.S. will be allowed to do things a little differently immediately following the deadline. 

According to Modern Healthcare, four states have been approved by the Centers for Medicare & Medicaid Services (CMS) to delay their transitions to direct ICD-10 code processing by the Oct. 1 deadline.ICD-10_iconMedcaid programs in California, Louisiana, Maryland and Montana received an exemption that allows those states to essentially work backwards. They'll take incoming claims coded in ICD-10, covert them into ICD-9 codes and then use the older coding system to calculate payments to healthcare providers.

This method is referred to as a "crosswalk" approach and allows the Medicaid fee-for-service programs in these four states to use the older codes as a workaround because of their current inability to perform payment calculations with the new ICD-10 codes.

CMS spokesman Jibril Boykin assured everyone that while this is the current approach they've decided to take in California, Louisiana, Maryland and Montana, this is far from a permanent or long-term plan.EMR/EHR ICD-10 Coding E-Book


"We have worked closely with each state to understand how they will mitigate any issues that may arise and minimize impact on the accuracy and timeliness of provider payments."

Reactions throughout the states are cautious, especially because of some of the risks involved with this crosswalk method. For example, there are some ICD-10 codes that do not convert back to ICD-9 codes, which could really complicate calculating payments at some of these Medicaid fee-for-service programs.

RELATED: CMS Claims Third Successful ICD-10 Coding Test

Despite the short-term exemptions, there are still plans in place for these states to purchase claims processing machines that will be able to handle ICD-10 codes directly, which will further streamline payments for healthcare providers.

For more information on ICD-10, click here to see how Nextech can help your practice ensure a smooth transition on Oct. 1.

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