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Medi-Cal to use ICD-10 crosswalk for claims payment

October 02, 2015
Area(s) of Interest: Payor Issues and Reimbursement Public Payors 


The California Department of Health Care Services (DHCS) did not convert from ICD-9 to the ICD-10 coding system by the federally mandated October 1, 2015, conversion date.


DHCS has received approval from the Centers for Medicare and Medicaid Services to take incoming claims coded with ICD-10 codes and convert them back to ICD-9 using a crosswalk in order to calculate payments. DHCS reports the crosswalk is a temporary workaround until the department is able to transition to a new claims processing system.


The California Medical Association (CMA) has requested that DHCS share more information, including how it plans to remedy any errors that are the result of the crosswalk, as well as the anticipated timeline for full ICD-10 implementation in the new claims processing system.


CMA will be monitoring the issue closely and will be in close contact with DHCS staff in the event any problems arise.


Practices that experience Medi-Cal related claim issues are encouraged to call Medi-Cal’s telephone service center at (800) 541-5555. For problems relating to global ICD-10 issues, contact the DHCS ICD-10 mailbox at ICD-10Medi-Cal@xerox.com.


CMA has a number of ICD-10 resources available to members, including a new FAQ, “Surviving ICD-10: An FAQ for physician practices.

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