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Provider Manual Section Updates for ICD-10

September 16, 2015

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

Updates to the provider manual sections include:

  • ICD-10 Clinical Modification (CM) codes replace ICD-9-CM Volume 1 and 2 codes
  • ICD-10 Procedure Coding System (PCS) codes replace ICD-9-CM Volume 3 codes
  • Claim form billing examples with an ICD-10-CM/PCS code use an ICD indicator of “0” in the appropriate field
  • Claim form billing examples use 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 refer to the Medi-Cal provider manuals for ICD-9-CM diagnosis and ICD-9-CM Volume 3 codes on or after September 16, 2015. Providers can still view ICD-9 policy in the ICD-9 Policy Holding Library on the ICD-10 page of the Medi-Cal website. Refer to the ICD-9 Policy Holding Library for ICD-9 policy for dates of service/dates of discharge effective through September 30, 2015.

For general ICD-10 information, click on the ICD-10 FAQs.