ICD-10 CM/PCS Compliance Date Revision

PROVIDER ALERT

On April 1, 2014, it was announced that the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. No. 113-93) was enacted, which included language that the U.S. Department of Health and Human Services (DHHS) Secretary may not adopt ICD-10 prior to Oct. 1, 2015. Accordingly, DHHS has released a final rule that includes a new compliance date that requires the use of ICD-10 beginning Oct. 1, 2015. The rule will also require Health Insurance Portability and Accountability Act (HIPAA) covered entities to continue to use ICD-9-CM through Sept. 30, 2015.

The South Carolina Department of Health and Human Services (SCDHHS) has updated its plan to align with the new compliance date. Effective Oct. 1, 2015, claims submitted to SCDHHS must include the ICD-10 diagnosis codes for any claim with a date of service or date of discharge on or after Oct. 1, 2015. A claim with a date of service or date of discharge from Sept. 30, 2015 or before must contain ICD-9 codes. 

SCDHHS will continue to share information related to the preparation and implementation of ICD-10 with providers through alerts, bulletins and the dedicated ICD-10 webpage ( https://msp.scdhhs.gov/aca/ ).

This alert applies to Fee-For-Service and Medical Homes Networks (MHNs). Please monitor the appropriate Managed Care Organization (MCO) for its instructions regarding ICD-10 implementation. If you have any questions about this announcement, please contact the South Carolina Healthy Connections Provider Service Center at (888) 289-0709. Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.

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