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Upcoming Provider Manual Section Updates for ICD-10

August 6, 2015

Effective October 1, 2015, Medi-Cal provider manual sections will be updated with the International Classification of Diseases, 10th Revision (ICD-10) codes and policy. Medi-Cal provider manual sections will be updated to comply with the Health Insurance Portability Accountability Act.

Updates to the provider manual sections include:

  • ICD-10 Clinical Modification (CM) codes will replace ICD-9-CM Volume 1 and 2 codes
  • ICD-10 Procedure Coding System (PCS) codes will replace the ICD-9-CM Volume 3 codes
  • Claim form billing examples with an ICD-10-CM/PCS code will include an ICD indicator of “0” in the appropriate field
  • Claim form billing examples will include generic ICD-10-CM/PCS place holder codes. For example:
    • D1D1D1D for primary ICD-10-CM codes, D2D2D2D for Secondary ICD-10-CM codes etc.
    • P1P1P1P for ICD-10-PCS codes

Providers will no longer be able to use ICD-9-CM diagnosis and procedure codes for health care services provided on or after October 1, 2015. A link to provider manual sections containing ICD-9 billing policy – for reference purposes only – will be included in a future Medi-Cal Update.

For a draft of the upcoming manual section changes for ICD-10, click on the Draft ICD-10 Code Release Disclaimer link on the ICD-10 page of the Medi-Cal website. For general ICD-10 information, click on the ICD-10 FAQs.