Home Health ICD-9/ICD-10 Alert

Published on Mon Sep 08, 2008 PDF

Are you ready for the new and updated ICD-9 diagnosis codes effective Oct. 1? As you make the transition, episode date is the factor you must know when deciding whether to bill a 2008 code or a 2009.

Now that SCIC billing is no longer available, diagnosis codes must match on the RAP and the final claim. For more on this, see in Section 40.2, Chapter 10 of the Medicare Claims Processing Manual. The Centers for Medicare & Medicaid Services expects that diagnosis codes assigned to the RAP are compliant with official ICD-9-CM coding guidelines and that in most cases a matching code will be assigned to the final claim.

So, for episodes beginning before Oct. 1, use the 2008 codes for the RAP and the final claim, even if the episode date is after Oct 1.

For episodes beginning on or after Oct. 1, use the 2009 codes for the RAP and the final claim.

Use dates of episode (the "from" date on the certification), NOT date of assessment (M0090).