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Today Medicaid issued the attached bulletin regarding how prior authorizations will be handled before and after implementation of ICD-10 on October 1, 2015. Hopefully you are aware that effective October 1, 2015, you will be required to utilize the ICD-10 coding system on all bills submitted to Medicaid. ICD-10 is frequently used as a catch-all term for ICD-10-CM (clinical modification) and ICD-10-PCS (procedural coding system), but most often refers to ICD-10-CM. ICD-10-CM is the set of medical diagnosis codes used for outpatient and inpatient services. There are approximately 69,000 ICD-10-CM codes, compared to approximately 13,600 ICD-9-CM codes.ICD-10-PCS codes are used for inpatient services. There are approximately 72,000 ICD-10-PCS codes. These changes will apply to both group home and waiver billing. While you may only use a few billing/procedure codes, other fields on the billing forms may require changes as well. Many providers have been preparing for this conversion and testing their systems over the past several months in the same manner that HP has been testing the state systems. To assist you in assessing your preparedness, we have attached several FAQs relative to claims, coding, etc. from the Indiana Medicaid ICD-10 information website: http://provider.indianamedicaid.com/general-provider-services/icd-10-information.aspx An example of four questions that may impact your agency: Q. Who will be responsible for making sure providers use the correct codes? A. Providers are responsible for becoming familiar with the code sets and guidelines to be sure the correct codes are assigned. Q. Will ICD-10 affect my revenue flow? A. ICD-10 may affect your revenue stream if you are not prepared! If you are well-prepared and provide correct codes, your revenue stream will not be interrupted. Q. Everything I read states we should be getting ready for ICD-10. Where do I start? A. Begin by visiting the roadto10.org at the CMS website. Also, the IHCP urges you and your staff to prepare for ICD-10 by coding one claim a day in both ICD-9 and ICD-10. Now is the time to become familiar with the new code set. The IHCP encourages you to use these ICD-10-coded claims for testing with the IHCP through your clearinghouse and software vendor during the vendor testing time frame. Providers may also use the ICD-10 manual at the Center for Disease Control website at cdc.gov. You can find additional information about ICD-10 on the ICD-10 Provider Resources page at the CMS website at cms.gov. If you have questions, contact the ICD-10 Questions mailbox (INXIX.ICD10Questions@HP.com) Q. What should we do about our computer systems? A. Contact your clearinghouses and software vendor to address concerns. Also, review your file layouts and where your files are stored to be sure the fields and your system can accommodate the additional code length. Many thanks to INARF’s Medicaid Consultant Bradley & Associates for compiling this reminder. If you have any questions, please do not hesitate to contact Tracy Mitchell (tracym@bradleycpa.com) or Dan Gaafar (dang@bradleycpa.com) at Bradley & Associates 317-237-5500.