Starting October 1, the Centers for Medicare and Medicaid Services (CMS) will require ICD-10 codes for reimbursement. Macro Helix is now accepting and processing ICD-10 data, and we are ready to assist you with your ICD-10 preparation, including data validation and testing.

Please email Macro Helix Customer Support or call 888.462.4526 to begin the data validation process.

 

Frequently-Asked Questions

To help you prepare for this transition, we’ve compiled a list of ICD-10 FAQs:

Why should I convert from ICD-9 to ICD-10?

The structure of ICD-9 limits the number of new codes that can be created and the data about patients’ medical conditions. ICD-10 codes allow for more specific diagnosis code assignment and help improve patient safety.

Do I have to transition to ICD-10?

Healthcare providers, payers, clearinghouses and billing services covered by HIPAA, not just entities who submit Medicare or Medicaid claims, must comply with the transition to ICD-10.

How long do I have to transition to ICD-10?

CMS requires that you submit Medicaid and Medicare reimbursements with ICD-10 codes starting October 1, 2015. See the table below for other key dates during this process:

Date Description
July 2015 Macro Helix will process both ICD-9 and ICD-10 codes
October 1, 2015 CMS compliance deadline for transition to ICD-10

 

Will you help me prepare for ICD-10?

We are ready to assist you with your ICD-10 preparation, including data validation and testing. As part of our customer education for Release v2015.2.1, we will provide you with an ICD-10 overview during our release webinars and through our 340B Architect online help.

Please email Macro Helix Customer Support or call 888.462.4526 to begin the data validation process. Our Data Validation (DV) team will work with you to implement any corrections required to your data feeds and ensure you are compliant with the new requirements. Do NOT make any changes to your current data feeds until you have spoken with a member of the DV team.

Is there a fee associated with your ICD-10 services and updates?

No, the ICD-10 transition is part of Macro Helix’s scheduled release updates.

Do I need to purchase any new hardware to prepare for ICD-10?

No, 340B Architect is web-based and does not require you to purchase any additional hardware.

Will the transition to ICD-10 affect my contract pharmacies?

Prescription qualification may be impacted by the transition to ICD-10 due to the significant increase in the number of available diagnosis codes.

How does ICD-10 affect my data feed to Macro Helix?

Prior to sending ICD-10 codes, your patient encounter data feeds will need an additional indicator that allows our software to complete ICD-9 or ICD-10 matches. ADT feeds sent via HL7 also require updates.

The Patient Encounter/Visit Feed must contain the following:

  • All prefixes, zeros and decimal points when sending diagnosis codes.
  • An indicator (ICD9 vs. ICD10) before the first diagnosis code (e.g., …ICD10|A78|A69.21).
  • Each row contains all ICD-9 or ICD-10 diagnosis codes. Do not mix the codes together.

Will you still process ICD-9 codes after October 1, 2015?

Yes, you may continue to send ICD-9 codes to our systems after October 1.

Can you process both ICD-9 and ICD-10 codes for the same visit?

We will maintain both ICD-9 and ICD-10 codes and continue to test all prescriptions against any coding you send. Please ensure that each row contains all ICD-9 or ICD-10 diagnosis codes. Do not mix the codes together.

Where can I find more information on ICD-10?

Go to http://www.cms.gov/ICD10 for more details.