Pediatric Coding Alert

California’s Medicaid payer isn’t quite ready to accept ICD-10 codes.

Although you’re required to submit ICD-10 codes to California Medicaid starting on Oct. 1, the payer is not ready to accept them.

“Medi-Cal will be using a crosswalk solution in the legacy California Medicaid Management Information System (CA-MMIS),” the Medicaid payer says on its website. “Medi-Cal has mapped all ICD-10 codes to corresponding ICD-9 codes starting with the General Equivalence Mappings (GEMs) provided by CMS and modifying the mappings to align with existing Medi-Cal policy. Claims will be run against the crosswalk to determine the ICD-9 value to process through the system.”

While many practices are questioning why they have to submit ICD-10 codes if Medi-Cal clearly isn’t ready to accept them, the payer says it will step up and accept ICD-10 codes in the near future. “The crosswalk will only be used temporarily for ICD-10 claim adjudication while the implementation of our new MMIS system is being completed,” Medi-Cal says. “Once the new system is online, Medi-Cal will adjudicate all claims natively using ICD-10 and the crosswalk will no longer be used.”

The insurer will not be publishing its crosswalk and expects practices to submit the appropriate ICD-10 code based on documentation and information in the provider manuals.

Resource: To read Medi-Cal’s ICD-10 Frequently Asked Questions, visit http://files.medi-cal.ca.gov/pubsdoco/hipaa/hipaa_icd10_faqs.asp .