The change-over is here, and the NCMS has compiled a number of resources that can help should you encounter any problems after October 1.
Steps to follow should you have any complaints or issues:
- If the payer is Medicare:
- Check your Palmetto GBA website for information on problems they are addressing and for a method of contact for ICD-10 issues.
- If the payer is Medicaid, check the state Medicaid website for information and method of contact.
- If the payer is a commercial payer, check their website for information and method of contact.
- If you are having issues with your practice management system or electronic health record (EHR), contact your vendor.
- If you are having issues with your billing vendor or clearinghouse, contact them.
The tabs below have contact information and additional details on ICD-10 to assist you.
- Medicaid – 800-688-6696; NCTracksprovider@nctracks.com
- Palmetto GBA Medicare – 855-696-0705; Palmetto GBA
- If you experience any problems in the processing of your Medicare claims or other Medicare administrative transactions, you may complete and submit an ICD-10 complaint form to the Centers for Medicare & Medicaid Services (CMS).Please note: This is for Medicare only. Forms will be sent directly to the Centers for Medicare & Medicaid Services. Sending this email constitutes your authorization for the information to be supplied to CMS. The American Medical Association will not provide individual responses to each complaint. Please complete and send an ICD-10 complaint form.
- The complaint form above will be sent to the CMS ICD-10 ombudsman. You can contact the ombudsman directly at email@example.com.
- BCBSNC – 800-214-4844 – Provider Blue Line; 888-333-8594 – eSolutions Helpdesk
From BCBSNC: The ICD-10 information on the BCBSNC provider section on our website is located at http://www.bcbsnc.com/content/providers/legislative/icd10.htm. There are some very informative ICD-10 articles on the Important News page at http://www.bcbsnc.com/content/providers/news-and-information/important-news.htm as well.
ICD-10 Electronic Claims Tips
October 1, 2015 is the ICD-10 compliance date. Claim submissions for services on or after 10/1 must contain ICD-10 codes or they will be rejected. Providers who file electronically with BCBSNC or utilize a clearinghouse for electronic submissions should check their Electronic Claims Audit Report daily for rejected claim submissions. Providers can access these report for 14 days after submission through Blue e 837 Claim Error Listing.
For Blue e claims, the Version Number on CMS1500 Diagnosis Codes (Field 21) will default to a “0” effective 10/1. The UB04 Diagnosis/Procedure Code Qualifier (Block 66) will default to a “0”. The “0” indicates the diagnosis code is version ICD10. Change the diagnosis code version dropdown to a “9” for an ICD-9 code with dates falling prior to the compliance date.
For additional information on submitting ICD-10 codes on claims, review the Frequently Asked Questions at ICD-10 Updates. Contact BCBSNC’s eSolutions HelpDesk at 1-888-333-85941-888-333-8594 FREE for questions or issues with Blue e or HIPAA transactions.
- UHC – 800-842-8000; ICD10questions@uhc.com
Amy Poplin Dunatov, MPH, FACMPE, CCS-P, ICDCT-CM
Medical Practice Advisor
Phn: (919) 323-2081
Rose B. Shattuck, CPC, CCP, PCS
President/CEO, Rose Shattuck and Associates, LLC
4505 Fair Meadows Ln, Suite 205
Raleigh, NC 27607
Phn: (919) 256-1673
Cell: (919) 264-9643
Fax: (919) 645-3146
If your problem is not being resolved or to see if other practices have complained of similar issues, please contact our Solution Center Specialist Belinda McKoy here.