
ICD-9 and ICD-10 are not allowed on the same claim.

On INSTITUTIONAL INPATIENT CLAIMS, if the dates of service span 10/1/15, the entire claim requires
ICD-10 coding.

On PROFESSIONAL CLAIMS, if a global OB procedure code is present AND the dates of service span
10/1/15, the entire claim requires ICD-10 coding.

For ALL OTHER CLAIMS, if the dates of service span 10/1/15, the provider is required to split bill.

You must remember to change the ICD IND field when submitting claims with ICD-10 codes. o ICD IND=9
– entire claim requires ICD-9 coding and dates of service. o ICD IND=0
– entire claim requires ICD-10 coding and dates of service.
Electronic Claims

ICD-9 is NOT allowed into the MMIS system with dates of service on or after 10/1/15. You will receive a
999 or TA1 rejection .

ERROR CODE Y830
– Claims must not “mix” ICD-9 and ICD-10 Surgery Codes or Diagnosis Codes. o A “mixed” claim could be any of the following:
 Both ICD-9 and ICD-10 coding,
 ICD-9 coding with DOS on or after 10/1/15, or
 ICD-10 coding with DOS before 10/1/15.

ERROR CODE Y831
– Must split bill ICD-9 and ICD-10 when dates of service span 10/1/15.

ERROR CODE Y832
– Inpatient Claim must be ICD-10 only on or after 10/1/15.

ERROR CODE Y833
– Prof Global OB Claim must be ICD-10 only on or after 10/1/15.
Paper Claims

ERROR CODE 957 – Claims must not “mix” ICD-9 and ICD-10 Surgery Codes or Diagnosis Codes. o EOB 717
– Claim must not mix ICD-9 and ICD-10 diagnosis codes; must bill ICD-9 prior to
10/1/15; must bill ICD-10 on/after 10/1/15
– Rebill with only ICD-9 codes/dates of service or only
ICD-10 codes/dates of service. o EOB 725
– Claim must not mix ICD-9 and ICD-10 surgical procedure codes; must bill ICD-9 prior to 10/1/15; must bill ICD-10 on/after 10/1/15 – Rebill with only ICD-9 codes/dates of service or only
ICD-10 codes/dates of service.
 A “mixed” claim could be any of the following:
 Both ICD-9 and ICD-10 coding,
 ICD-9 coding with DOS on/after 10/1/15, or
 ICD-10 coding with DOS before 10/1/15. humanservices.arkansas.gov
Protecting the vulnerable, fostering independence and promoting better health

ICD-10 Billing and Compliance Tips/FAQs
Page 2

ERROR CODE 948
– Inpatient/Professional Global OB Claim must be ICD-10 only when DOS spans
10/1/15. o EOB 714 – Inpatient Claim must contain only ICD-10 surgical procedure and diagnosis codes when dates of service span 10/1/15. o EOB 715
– Professional Global OB Claim must contain only ICD-10 diagnosis codes when dates of service span 10/1/15.

ERROR CODE 949
– Must split bill ICD-9/ICD-10 when dates of service span 10/1/15. o EOB 713
– Dates of service spanning 10/1/15 must be split billed – Rebill (Bill ICD-9 prior to
10/1/15; bill ICD-10 on/after 10/1/15).
A crosswalk from ICD-9 to ICD-10 will NOT be provided. Please review the updated Arkansas Medicaid
Provider Manuals . The ICD codes have been removed from the provider manuals and DMS forms and replaced with a hyperlink to a corresponding Excel spreadsheet where there is a tab for ICD-9 codes and a tab for the ICD-10 codes. To complete claims, you may need to refer to an ICD-10 coding book or similar reference. Links to vendors of ICD-10-CM code books can be found at http://humanservices.arkansas.gov/dms/Pages/ICD-10.aspx
.
Where can I get more information about ICD-10?
Implementation information can be found on the Arkansas Medicaid website and the DHS ICD-10 web page .
Where can I find ICD-10 codes?
A crosswalk from ICD-9 to ICD-10 will NOT be provided. The ICD codes have been removed from the provider manuals and DMS forms and replaced with a hyperlink to a corresponding Excel spreadsheet where there is a tab for ICD-9 codes and a tab for the ICD-10 codes. You may also purchase the ICD-10 book to find codes.
I need assistance with a code translation from ICD-9 to ICD-10. Where can I find a list of code translations? Will you be able to help me find new codes if they deny?
HP and DMS are unable to provide code translations. Code assignment is based on documentation contained with the patient’s medical record. Code translation resources can be found at:
 https://www.aapc.com
 https://www.cms.gov/Medicare/Coding/ICD10/index.html?redirect=/icd10/
When will I be able to get a new ICD-10 code book?
If you have not obtained your 2015 ICD-10 code books, it’s not too late. They can be obtained through
Contexo, Optum, AAPC and AHIMA. Links for ordering a new code book are available on the Arkansas ICD-10 website .

ICD-10 Billing and Compliance Tips/FAQs
Page 3
Why can’t I enter ICD-10 codes using PES?
If you currently use PES, you MUST upgrade to version 2.23 or you will be unable to submit claims with ICD-10 codes. You must upgrade your software in sequential order; each lower version must be upgraded before you can upgrade to the next version. If you are currently using version 2.20, you MUST upgrade to 2.21, then 2.22, then 2.23, which is the latest version of PES. View or print PES upgrade instructions or download the upgrade now.
Dates of service on and after 10/1/2015 must be entered using ICD-10 codes.
What if my bill dates are before 10/1/2015?
If you are billing dates of service before 10/1/2015, you must use ICD-9 codes.
Can the Provider Assistance Center help me?
We expect call volume and wait times to increase related to ICD-10 billing issues. In order to expedite your wait time, please have the following information ready when you call:

MC0* Submitter ID

Rejection Codes (Edit numbers and EOB numbers)

ICN (for paper claims)

Batch number

Recipient ID Number

Patient Account Number
What dates do we start using ICD-10 codes?
Dates of service or dates of discharge on and after October 1, 2015 must bill using ICD-10 codes.
How do I enter ICD-10 codes into PES?
If you currently use Provider Electronic Solutions (PES) software to bill claims, you MUST upgrade to version
2.23 or you will be unable to submit claims with ICD-10 codes. PES 2.23 has been modified to allow submission of the longer, alphanumeric ICD-10 codes.
If you are unable to submit claims with ICD-10 codes using PES 2.23, then you may use the online billing system [Direct Data Entry (DDE)] to submit claims.
How do I file ICD-10 codes on paper claim forms?
The paper claim instructions have been updated for ICD-9 and ICD-10 in the Arkansas Medicaid provider manuals. The manuals also indicate the appropriate claim forms. Provider manuals are available on the
Arkansas Medicaid website at https://www.medicaid.state.ar.us/Provider/docs/docs.aspx
.

ICD-10 Billing and Compliance Tips/FAQs
Page 4
Will I get a new submitter ID?
No, a new submitter ID# will not be issued. Please continue to use the provider’s current number.
Do 783 providers have to change anything?
There are new forms for Alternative Care Providers. There is an ICD-9 form and an ICD-10 form. You will need to get those from your Case Manager. You will submit the ICD-9 form for dates of service before 10/1/2015 .
You will submit the ICD-10 form for dates of service on or after 10/1/2015 . If you are an Environmental
Provider and bill using form CMS-1500, then you will need to start using ICD-10 codes with dates of service on or after 10/1/2015 .
How will the ICD-10 transition/conversion affect my dental practice?
Dental providers are not impacted by the conversion to ICD-10 since Arkansas Medicaid does not require diagnosis codes for dental claims submission (electronic or paper claim form ADA J430).
CMS and the AMA have approved a grace period for submission of ICD-
10 codes. Why isn’t Arkansas
Medicaid allowing the same grace period?
The guidelines issued by CMS and the AMA are only applicable for Medicare Part B, Fee for Service claims.
They do not apply to Medicaid claims. The other components of the guidelines apply to submission of data for the Physician Quality Reporting System (RQRS) and Meaningful Use Attestation Data. These components are relevant to Medicare Only. All claims for dates of service on or after 10/1/2015 must be submitted using ICD-10 codes. This applies to Medicare, Medicaid, and commercial insurance claims. Additional information can be found on the Arkansas ICD-10 website as well as the CMS website .
There are 4 states that aren’t transitioning to ICD-10. Why aren’t they required to begin using ICD-10 on
October 1, 2015?
California, Louisiana, Maryland, and Montana have been approved by CMS to “crosswalk” claims that are submitted with ICD-10 codes back to ICD-9 codes so the claim can be processed. This is because the claims processing systems in those four states are unable to perform calculations using the new ICD-10 codes. It is unclear how long each of these four states will be allowed to continue this process since each state’s resolution timeframe is different according to CMS. The claims processing system in Arkansas has been updated to allow for submission of the longer, alphanumeric ICD-10 codes.
I am a Louisiana provider and not yet required to convert to ICD-10. How can I submit claims to
Arkansas now?
For dates of service before 10/1/2015, continue to submit your claims to Arkansas Medicaid as you always have.
For dates of service on or after 10/1/2015, you must submit claims to Arkansas Medicaid using ICD-10 codes.
If you use Arkansa s Medicaid’s PES software and have PES version 2.23, you may continue to submit claims electronically through this system. If you use Louisiana’s system or any other electronic claim delivery system, then you must submit your claims to Arkansas Medicaid on paper.