NCTracks
Public Health Programs and ICD-10
The transition to ICD-10 on October 1, 2015, affects the programs in the Division of Public Health in much the same way as it does other services, with a few exceptions.
Infant and Toddler Program
Prior approvals (PAs) for the Infant and Toddler Program (ITP) will use ICD-9 or ICD-10 codes based on the date of submission. PAs submitted before October 1 should use ICD-9 codes and PAs submitted on or after October 1 should use ICD-10 codes. PAs submitted before October 1 may cover dates of service beyond the October 1 cut-off date, even though they reflect ICD-9 codes, without causing an issue. However, all ITP claims submitted for dates of service on or after October 1 must use ICD-10 codes.
Sickle Cell Program
PA requests for Sickle Cell services cannot span the October 1 implementation date. Providers must obtain a new PA with ICD-10 codes for services rendered on or after October 1.
Sickle Cell claims submitted for dates of service on or after October 1 must use ICD-10 codes.
Early Hearing Detection and Intervention
PA requests for Early Hearing Detection and Intervention (EHDI) services cannot span the October 1 implementation date. Providers must obtain a new PA with ICD-10 codes for services rendered on or after October 1.
EHDI claims submitted for dates of service on or after October 1 must use ICD-10 codes.
Claims submitted with dates of service on or after October 1 for Sickle Cell or EHDI that do not have an approved PA request reflecting ICD-10 codes will be denied.