ICD-10 Coding Guidelines
CarePlus provides the following documents to assist coders in accurately coding and documenting diagnoses and services provided to CarePlus-covered patients:
ICD-10 Information
ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD). It contains codes that classify diseases and health problems. To learn more, review the following ICD-10 frequently asked questions and answers.
ICD-10 Frequently Asked Questions and Answers
All entities covered by the Health Insurance Portability and Accountability Act (HIPAA) of 1996 must now conduct healthcare transactions using the ICD-10 diagnosis and procedure codes.
Q. What is CarePlus' standard for ICD-10 acceptance?
A. CarePlus accepts ICD-10 codes on claims with a date of service or discharge date of Oct. 1, 2015, or after.
Q. Did CarePlus change medical necessity requirements because of the more specific codes that are available?
A. Yes. CarePlus has reviewed and updated medical necessity criteria to incorporate ICD-10 terminology and expanded coding.
Q. Did CarePlus update medical review policies, coverage determinations and payment determinations?
Yes. CarePlus has reviewed and updated medical necessity criteria to incorporate ICD-10 terminology and expanded coding.
