Frequently Asked Questions Regarding ICD-10

Please review the article below as well as this ICD-readiness help article.
Last updated 10/25/2015.   Printable View Printable View

  1. Do I need to create new ICD-10 claims for all currently treating patients on October 1?
    No. Just add ICD-10 codes to the existing ICD-9 claims. Please read the “important points” of the ICD-10 readiness help article linked above”. Invoices will be automatically created by ChiroPulse365 to include ICD9 or 10 based on carrier setup (assuming you use ICD9+10 compliant invoices, claims have ICD10 codes and carrier ICD-10 start date has been reached).

    ICD9_10claim

    Add an ICD-10 claim to the ICD-9 claim so you can invoice both 9 and 10 on this claim.

  2. Why does a New Patient (after the ICD-10 start date) still show an ICD-9 claim? For a New patient… delete the ICD-9 claim (if you see that) and create an ICD-10 claim. The logic when adding new patients will use ICD-10 later on but remember some carriers do not yet accept ICD-10. To Create a new ICD-10 claim use NEW CLAIM and select ICD-10 as shown below. If you CLONE an ICD-9 claim you must select “ICD-10” checkbox in the clone-claim window.
    cloneClaim

    Select the ICD-10 box to make the new claim ICD-10.

    Create New ICD-10 Claim

    Create New ICD-10 Claim

    ICD9_10new2

    Now you have new ICD-10 only claim

  3. I’m not sure what the claim buttons are when using current ICD-9 Claims for treating patients. Help!!!
    Claim buttons explained below...

    This is an ICD-9 claim with one ICD-9 ICD 307.81 Tension headache. See explanation  below…

    A – Used to add ICD-9 codes to this claim.
    B – Used to Add ICD-10 codes to this claim. USE THIS for active ICD-9 claims (like the example above) to add ICD-10 codes so you can invoice easily without creating a new ICD-10 claim.
    C – Attaches the selected/highlight ICD-9 code (307.81 tension headache selected above) and attaches it to all CPTs/treatments on the claim. Useful if an ICD is not mapped to visits for whatever reason. Remember to use VISIT WIZARD (step-by-step) to pick and choose which ICDs are mapped to each CPT/service.
    D –  Same as C but for the selected ICD-10. In the example above no ICD-10 code was yet added to the claim, so none can be selected.
    E – Takes the selected/highlighted ICD-9ICD-9 code (tension headache above) and prompts you to select a new ICD-9 to replace it on  visits on the claim. Useful to correct mistakes after posting many CPTs/visits.
    F –  Same thing but for ICD-10 codes.
    G – Smart matches ICDs and CPTs. Turn off if you are having difficulty, check your claims then re-enable it.
    H – Indicates this claim began as ICD-9 claim. If you add ICD-10 codes to this we’re still considering it as an ICD-9 claim. If you create a new ICD-10 claim it will indicate that.

  4. Will every insurance company be mandating ICD-10 codes starting on October 1, 2015?
    No. Some insurance companies such as worker’s compensation as well as PIP are not mandated to use ICD-10 codes so it is imperative that you check with your insurance company to see their requirements.
  5. What is the start date for ICD-10 coding?
    The start date is for dates of service beginning on October 1, 2015.
  6. Is every ICD-10 code entered into ChiroPulse?
    No, we added approximately 850 of the most commonly used codes for chiropractic into Chiropulse. Any additional codes that your office may need can be manually entered (see below make sure ICD-10 is checked). We will review and update these codes, possibly adding more as carriers such as Medicare weighs in on ICD-10 use.

    Add & save a new ICD-10 code.

    Add & save a new ICD-10 code.

  7. Where can I find a list of the ICD-10 codes? You can find the complete list at the CMS website? https://www.cms.gov/Medicare/Coding/ICD10/2016-ICD-10-CM-and-GEMs.html
  8. Can I send ICD- 9 and ICD-10 codes in the same batch file to my clearinghouse? ICD-9 and ICD-10 codes can be sent in the same file but NOT on the same claim. Therefore ChiroPulse365 automates this for you separating the use of ICD9 & ICD10.
  9. How do I turn on the ICD-10 code printing date for every insurance company?
    Go the the insurer tab and click the ICD readiness button. From the menu select Set ICD-10 start dates for all carriers.Clipboard01
  10. How do I turn on the ICD-10 code printing date for just one insurance company? Go to the insurer tab and double click the insurer. Enter the ICD-10 start date and press save. Clipboard01
  11. I made a mistake with the start date for one insurance company, how do I correct it? Go to the insurer tab and double click the insurer. Change the ICD-10 start date and press save. Clipboard01
  12. How do I add an ICD-10 code that is not in Chiropulse? Go to the code/product tab and click on Add New Code. Select ICD for the code type and check the box that says ICD-10. Add the rest of the information in the window.  Be sure to add the chapter number for the code (from your coding book) and if it is an external type code so that it can be searched in the claim wizard. Press Save. Clipboard01
  13. Can I delete any of the pre-loaded codes? No, but you can make then inactive. To make a code inactive go to the code/product tab and double click the code you want to make inactive. Then check the inactive box. Clipboard01
  14. How do I submit a claim with ICD-10 for a real patient to a real insurer? Should I send test claims first?
    We recommend you contact your carrier/clearinghouse and see if a test patient can be submitted. For a clearinghouse you can use “test mode” by going to “clearinghouse & EDI Setup” from the Utilities menu. Then select the clearinghouse & check “Use Test Mode” then save. Clipboard01Next go to the Insurance tab and find the specific carrier assigned to the test patient (or edit the insurance carrier from page2 Patient Wizard) then set the ICD-10 Start to today or earlier. Finally open the latest claim and enter ICD-10s in the current claim (which should have ICD-9 codes already assigned). Now add test visits then run Billing Invoice Wizard and invoice that patient for today. This creates a cms form/edi file with only the ICD-10 codes. The EDI file will be tagged as “testing”. When completed turn off “test mode” for the clearinghouse and set the “ICD-10 date” to 10/1/2015 or as needed.
  15. How do I submit a claim for Clearinghouse/Carrier Testing prior to 10/1?
    Please see the above question #9 above. If you are sending printed CMS forms there is no “test mode” option so discuss with your clearinghouse how to proceed.
  16. How do I submit a test claim for ICD-10 compliance to MDOL, now a part of the Ability Network? Call tech support at 888-499-5465 and let them know you would like to send a test file. They will add a feature to your website called send test claims where you can upload your file. The file submitted should include 5 claims and one from Medicare.
  17. The frequently used ICD-10 codes for subluxation end with the letter “A” for initial encounter. Do I have to manually add all the same codes with the last letter of “D” for subsequent encounter?
    At this time only the “A”/Initial ICD-10 codes are to be used (allowed by carriers).  “D”/subsequent is not used at this time.
  18. How do i print a list of ICD-10 codes setup in ChiroPulse?
    You can print the ICD list in Reports… Office Maintenance… ICD Code List… then print or save as PDF or other file. The ICD-10 codes begin with a letter (not a numeric) so you can begin printing on that page if you want to skip the ICD-9 codes.
  19. I submitted new ICD-10 codes and were rejected. Why?
    You must call your carrier/clearinghouse to determine why any claims are rejected. Please remember that software vendors, carriers and clearinghouses all are facing an unprecedented scenario of ICD-10 implementation. ICD-10 workshops & seminars recommended offices prepare for delays of up to 3 months in collections by 3rd party payers.
  20. I am getting “unable to auto-create visit errors in ChiroPulse?
    You should not be getting this with refresh .1951 or higher but if it occurs it is  due to mapping of CPTs in an ICD-9 claim to the newly added ICD-10 codes. Use VISIT WIZARD to post visits for a few weeks and turn on STEP-BY-STEP (Patient Tab click Visit Wizard.

    Turn on Step-by-step Visit Wizard for a few weeks after ICD-10 live date.

    Turn on Step-by-step Visit Wizard for a few weeks after ICD-10 live date.

  21. The invoices we are sending electronically do not include the ICD-10 codes but our paper 02-12 form is correct.
    Only these ChiroPulse billing insurance invoices support ICD-10+9…
    CMS-1500 2014 – paper (HCFA2007 is ICD-9 only)
    Ansi 837 Pro 5010 – electronic
    HCFA Print Image w/ Plain Text 2014 Special Config (EDI – Plain Text  2014) – electronic

    Edi837Pro

    ANSI 837 Pro 5010

    EdiPlainText2014

    HCFA Print Image (EDI Format), Plain Text 2014 (Special Config)

    Prior CMS/EDI forms used are not ICD-10 compliant. Make sure to setup your clearinghouses to use the appropriate “EDI Format”

    After setting up the clearinghouse you must use (select) that specific clearinghouse in Billing Wizard step 3 for “HCFA TYPE”  choice.

  22. Stay tuned for updates to this article…