Not able to submit ICD 10 What is alternative method? what is alternative method – part 2
Information about the free billing software is available on each of the CMS Contractor websites. Please refer to the document that provides web page access to all Contractors titled Contractors’ ICD-10 Claims Submission Alternatives Web Pages on the CMS website.
Please note that submitting electronic claims to Medicare using the free billing software does not change the requirement for ICD-10 compliant claims to be submitted for FROM dates of service on or after October 1, 2015. Any claims
containing ICD-9 codes for FROM dates of service on or after October 1, 2015, will be rejected by Medicare.
In some cases, you may be able to use your MAC’s provider internet portal to submit ICD-10 compliant professional claims. All MACs offer the portals, and a subset of these MAC portals offer claims submission. Provider portal internet claim submission is not available for institutional or supplier claims.
Information about registering for access to provider internet portals is available on each of the CMS Contractor websites. Please refer to the document that provides web page access to all Contractors titled Contractors’ ICD-10 Claims Submission Alternatives Web Pages on the CMS website.
Please note that claims submitted via our provider portal must contain ICD-10 codes for FROM dates of service on or after October 1, 2015. Those submitted containing ICD-9 codes for FROM dates of service on or after October 1, 2015, will be
rejected through normal claims editing processes. ICD-9 codes will still be accepted for FROM dates prior to October 1, 2015.
DDE
Providers that bill institutional claims are also permitted to submit claims electronically via DDE screens. DDE requires a connectivity service provided by an external company to establish the connection.
Information about registering to submit claims via DDE and lists of DDE service vendors is available on each of the CMS Contractor websites. Please refer to the document that provides web page access to all Contractors titled Contractors’ ICD-10 Claims Submission
Alternatives Web Pages on the CMS website.
Please note that claims submitted via DDE must contain ICD-10 codes for dates of DISCHARGE/THROUGH dates on or after October 1, 2015. Those submitted containing ICD-9 codes for dates of DISCHARGE/THROUGH dates on or after
October 1, 2015, will be Returned to Provider (RTP).
PAPER CLAIMS
In limited situations, you may submit paper claims with ICD-10 codes to Medicare. To find more information on when you may submit paper claims, visit http://www.cms.gov/Medicare/Billing/ElectronicBillingEDITrans/ASCAWaiver.html
on the CMS website. Please note that to submit paper claims, you must meet the requirements to qualify for a waiver of the Administrative Simplification Compliance Act (ASCA) provisions.
Information about submitting paper claims and ordering claim forms is available on each of the CMS Contractor websites. Please refer to the document that provides web page access to all Contractors titled Contractors’ ICD-10 Claims Submission Alternatives Web Pages on the CMS website.
Information and Resources
Visit the following web pages to find information and resources that will assist you in submitting ICD-10 codes to Medicare:
• General ICD-10-CM/PCS information:
http://www.cms.gov/Medicare/Coding/ICD10/index.html;
• ICD-10 Fee-For-Service provider resources including claims processing and billing, coding, unspecified ICD-10-CM codes, home health provider information, NCDs and LCDs, testing and results, features and benefits, and calls and background:
https://www.cms.gov/Medicare/Coding/ICD10/Medicare-Fee-for-ServiceProvider-Resources.html;
• General Equivalence Mappings:
http://www.cms.gov/Medicare/Coding/ICD10/2015-ICD-10-CM-andGEMs.html;
and
• ICD-10 National Coverage Determinations:
http://www.cms.gov/Medicare/Coverage/CoverageGenInfo/ICD10.html on the CMS website.
Information about the free billing software is available on each of the CMS Contractor websites. Please refer to the document that provides web page access to all Contractors titled Contractors’ ICD-10 Claims Submission Alternatives Web Pages on the CMS website.
Please note that submitting electronic claims to Medicare using the free billing software does not change the requirement for ICD-10 compliant claims to be submitted for FROM dates of service on or after October 1, 2015. Any claims
containing ICD-9 codes for FROM dates of service on or after October 1, 2015, will be rejected by Medicare.
In some cases, you may be able to use your MAC’s provider internet portal to submit ICD-10 compliant professional claims. All MACs offer the portals, and a subset of these MAC portals offer claims submission. Provider portal internet claim submission is not available for institutional or supplier claims.
Information about registering for access to provider internet portals is available on each of the CMS Contractor websites. Please refer to the document that provides web page access to all Contractors titled Contractors’ ICD-10 Claims Submission Alternatives Web Pages on the CMS website.
Please note that claims submitted via our provider portal must contain ICD-10 codes for FROM dates of service on or after October 1, 2015. Those submitted containing ICD-9 codes for FROM dates of service on or after October 1, 2015, will be
rejected through normal claims editing processes. ICD-9 codes will still be accepted for FROM dates prior to October 1, 2015.
DDE
Providers that bill institutional claims are also permitted to submit claims electronically via DDE screens. DDE requires a connectivity service provided by an external company to establish the connection.
Information about registering to submit claims via DDE and lists of DDE service vendors is available on each of the CMS Contractor websites. Please refer to the document that provides web page access to all Contractors titled Contractors’ ICD-10 Claims Submission
Alternatives Web Pages on the CMS website.
Please note that claims submitted via DDE must contain ICD-10 codes for dates of DISCHARGE/THROUGH dates on or after October 1, 2015. Those submitted containing ICD-9 codes for dates of DISCHARGE/THROUGH dates on or after
October 1, 2015, will be Returned to Provider (RTP).
PAPER CLAIMS
In limited situations, you may submit paper claims with ICD-10 codes to Medicare. To find more information on when you may submit paper claims, visit http://www.cms.gov/Medicare/Billing/ElectronicBillingEDITrans/ASCAWaiver.html
on the CMS website. Please note that to submit paper claims, you must meet the requirements to qualify for a waiver of the Administrative Simplification Compliance Act (ASCA) provisions.
Information about submitting paper claims and ordering claim forms is available on each of the CMS Contractor websites. Please refer to the document that provides web page access to all Contractors titled Contractors’ ICD-10 Claims Submission Alternatives Web Pages on the CMS website.
Information and Resources
Visit the following web pages to find information and resources that will assist you in submitting ICD-10 codes to Medicare:
• General ICD-10-CM/PCS information:
http://www.cms.gov/Medicare/Coding/ICD10/index.html;
• ICD-10 Fee-For-Service provider resources including claims processing and billing, coding, unspecified ICD-10-CM codes, home health provider information, NCDs and LCDs, testing and results, features and benefits, and calls and background:
https://www.cms.gov/Medicare/Coding/ICD10/Medicare-Fee-for-ServiceProvider-Resources.html;
• General Equivalence Mappings:
http://www.cms.gov/Medicare/Coding/ICD10/2015-ICD-10-CM-andGEMs.html;
and
• ICD-10 National Coverage Determinations:
http://www.cms.gov/Medicare/Coverage/CoverageGenInfo/ICD10.html on the CMS website.