Date

MO HealthNet Division (MHD) providers filing claims should choose the correct International Classification of Diseases (ICD) code. The date of service will determine whether the diagnosis code set value must be ICD-9th revision or ICD-10th revision.  The date of service determines the ICD code, not the filing date.   Providers are encouraged to file claims on the MHD electronic billing portal, emomed.

When dates of service span across September 2015, and October 2015, the provider has to choose the correct ICD code to record on the claim.  The provider cannot bill both an ICD-9th revision and ICD-10th revision diagnosis code on the same claim.  Reference the following guidelines for recording the appropriate ICD code.

Medical, Outpatient, Home Health, Dental, Professional Crossover claim types:

The provider choses the appropriate ICD code based off the Date of Service (DOS), which can be referenced as from or through DOS.

  • Use the ICD-9 Codes: From DOS and through DOS are on and prior to September 30, 2015.
  • Use the ICD-10 Codes: On and after October 1, 2015.

Medical, Professional Crossover claim types for Durable Medical Equipment (DME):

The provider choses the appropriate ICD code based off the start DOS, which can be referenced as from DOS.  If the DOS starts in September 2015, and ends in October 2015, the provider records the ICD-9 code on the claim.

  • Use the ICD-9 Codes: From DOS are on and prior to September 30, 2015.
  • Use the ICD-10 Codes: On and after October 1, 2015.

Inpatient, Nursing Home, Institutional Crossover claim types:

The provider choses the appropriate ICD code based off the discharge DOS, which can be referenced as end or through DOS.  If the DOS starts in September 2015, and ends in October 2015, the provider records the ICD-10 code on the claim.

  • Use the ICD-9 Codes:  Discharge DOS are on and prior to September 30, 2015.
  • Use the ICD-10 Codes: Discharge DOS are on and after October 1, 2015.

Please reference the Provider Bulletin, International Classification of Diseases (ICD) 10th Revision, discussing MHD claims processing.