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Changes to Real-Time Internet Pharmacy

September 5, 2014

Effective September 22, 2014, Real-Time Internet Pharmacy (RTIP) submissions require an ICD indicator value in the new ICD-CM Type field. The new ICD-CM Type field displays just before the Primary ICD-CM field on the “General Tab” of the Pharmacy Claim Submission screen.

Pharmacy Claim Submission

Available Field Values
The following values are available in the new ICD-CM Type field:

a. NONE
b. ICD-9
c. ICD-10

Users should choose the value “NONE” only if the claim does not require an ICD code in the Primary Diagnosis Code field. The value “NONE” is the default value in the new ICD-CM Type field.

Users choosing the value “ICD-9” require an ICD-9 code in the Primary Diagnosis Code field. The Secondary Diagnosis Code field is optional. Since ICD-9 codes are required through September 30, 2015, only ICD-9 codes should be submitted on claims.

The value “ICD-10” will not be used until October 1, 2015, as ICD-10 codes cannot be submitted on claims before that date.