GENERAL INFORMATION 2018 ICD Implementation On October 1, 2017, the Texas Medicaid & Healthcare Partnership (TMHP) applied the 2018 annual International Classification of Diseases (ICD) updates that are effective for dates of service on or after October 1, 2017. The annual ICD updates include the following: • ICD-10 Clinical Modification (ICD-10-CM) • ICD-10 Procedure Coding System (ICD-10-PCS) This combined Special Bulletin includes the ICD updates for Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program. This bulletin is intended to notify providers of program and coding changes related to the 2018 updates for ICD and Current Procedural Terminology (CPT®). All providers are encouraged to review the “General Information” section of this bulletin. Policy updates for a specific program or provider type are discussed in designated sections of the bulletin. Claims Filing The new 2018 ICD diagnosis codes and inpatient hospital surgical procedure codes may be billed beginning October 1, 2017. Important: To avoid fraudulent billing, providers must submit the ICD codes that are most appropriate for the services provided. The ICD-10-PCS procedure codes are inpatient hospital surgical procedure codes and must be submitted, as applicable, only on inpatient hospital claims. Note: For professional and outpatient procedures and services, providers must continue to use the American Medical Association (AMA) Current Procedural Terminology (CPT) Manual and the CMS Health Care Common Procedure Coding System (HCPCS) Manual. ICD-10 Special Bulletin, No. 12 October 2017
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ICD-10 - tmhp.com · • ICD-10 Clinical Modification (ICD-10-CM) • ICD-10 Procedure Coding System (ICD-10-PCS) This combined Special Bulletin includes the ICD updates for Texas
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GENERAL INFORMATION
2018 ICD ImplementationOn October 1, 2017, the Texas Medicaid & Healthcare Partnership (TMHP) applied the 2018 annual International Classification of Diseases (ICD) updates that are effective for dates of service on or after October 1, 2017. The annual ICD updates include the following:
• ICD-10 Clinical Modification (ICD-10-CM)
• ICD-10 Procedure Coding System (ICD-10-PCS)
This combined Special Bulletin includes the ICD updates for Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program. This bulletin is intended to notify providers of program and coding changes related to the 2018 updates for ICD and Current Procedural Terminology (CPT®).
All providers are encouraged to review the “General Information” section of this bulletin. Policy updates for a specific program or provider type are discussed in designated sections of the bulletin.
Claims FilingThe new 2018 ICD diagnosis codes and inpatient hospital surgical procedure codes may be billed beginning October 1, 2017.
Important: To avoid fraudulent billing, providers must submit the ICD codes that are most appropriate for the services provided.
The ICD-10-PCS procedure codes are inpatient hospital surgical procedure codes and must be submitted, as applicable, only on inpatient hospital claims.
Note: For professional and outpatient procedures and services, providers must continue to use the American Medical Association (AMA) Current Procedural Terminology (CPT) Manual and the CMS Health Care Common Procedure Coding System (HCPCS) Manual.
Inpatient Hospital ICD-10-PCS Surgical Procedure Code and Diagnosis Related Group (DRG) Updates ................................................................................. 20
ICD-10 Special Bulletin, No. 12 3 2017 Texas Medicaid
General Information
CPT only copyright 2016 American Medical Association. All rights reserved.
MEDICAID FEE-FOR-SERVICE AND MANAGED CARE PROVIDERS
Texas Medicaid ICD UpdatesThe 2018 Internaltional Classification of Diseases (ICD) updates for Texas Medicaid are included in the ICD tables in the All Code Changes: Added, Revised, and Discon-tinued section of this bulletin beginning on page “All Code Changes: Added, Revised, and Discontinued” on page 16. The 2018 ICD deletions and replacements are effective October 1, 2017, for dates of service on or after October 1, 2017, for Texas Medicaid. Providers may refer to the “General Information” section for more information.
Texas Medicaid Benefit Changes
The following Texas Medicaid benefit changes have been made to support the 2018 ICD-CM diagnosis code updates and are effective for dates of service on or after October 1, 2017. For more information, call the Texas Medicaid & Healthcare Partnership (TMHP) Contact Center at 1-800-925-9126.
Note: These changes apply to Texas Medicaid fee-for-service and Medicaid managed care claims and authorization requests that are submitted to TMHP for processing.
The policy articles in this bulletin contain the following information:
• Revised: The description has been revised for these diagnosis codes. Providers may refer to the appropriate copyright holder for the revised descriptions.
• Discontinued: Discontinued diagnosis codes are no longer reimbursed after September 30, 2017.
• Added: Added diagnosis codes are new diagnosis codes added by the Centers for Medicare & Medicaid Services (CMS).
Ambulance Services
The following emergency medical condition codes must be used to identify emergency medical conditions for ambulance transports:
An emergency ambulance transport may be reimbursed by Texas Medicaid when it is submitted with modifier ET and one or more emergency medical condition codes.
The requesting facility or physician must include with the claim documentation that describes the clients’ condition which necessitated the ambulance transport. Medicaid recognizes limitations of usual ambulance personnel for establishing a diagnosis, and recognizes coding of a client’s condition using International Classification of Diseases,
ICD-10 Special Bulletin, No. 12 4 2017 Texas Medicaid
Medicaid Fee-For-Service and Managed Care Providers
CPT only copyright 2016 American Medical Association. All rights reserved.
10th Revision, Clinical Modification (ICD-10-CM) when reporting ambulance transport services may be less specific than for services reported by other professional providers.
Providers who submit ICD-10-CM diagnosis codes should choose the code that best describes the client’s condition at the time of transport. Diagnoses that are “rule out” or “suspected” diagnoses should not be reported using specific ICD-10-CM diagnosis codes. In such instances where a diagnosis is not confirmed, it is more correct to use a symptom, finding, or injury diagnosis code.
Refer to: The current Texas Medicaid Provider Procedures Manual, Ambulance Services Handbook, section 2.2.1 “Emergency Ambulance Transport Services,” for more information.
Refer to: The current Texas Medicaid Provider Procedures Manual, Inpatient and Outpa-tient Hospital Services Handbook, section 4.2.6 “Cardiac Rehabilitation,” for more information.
Colony Stimulating Factors
The following diagnosis codes may be reimbursed when submitted with procedure codes J1442, J1447, J2505, J2820, and Q5101:Added Diagnosis CodesC9620 C9621 C9622 C9629 D4701 D4702 D4709Discontinued Diagnosis CodeC962
Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook, section 9.2.38.38 “Colony Stimulating Factors (Filgrastim, Pegfilgrastim, and Sargramostim),” for more information.
Cytogenetics
The following diagnosis codes may be reimbursed when submitted with procedure codes 88230, 88233, 88235, 88237, 88239, 88245, 88248, 88249, 88261, 88262, 88263, 88264, 88271, 88272, 88273, 88274, 88275, 88280, 88283, 88285, 88289, and 88291:Added Diagnosis CodesP2930 P2938 Q53111 Q53112 Q5313 Q53211 Q53212
ICD-10 Special Bulletin, No. 12 5 2017 Texas Medicaid
Medicaid Fee-For-Service and Managed Care Providers
CPT only copyright 2016 American Medical Association. All rights reserved.
Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook, section 9.2.39.6 “Cytogenetics Testing,” for more information.
Diagnostic Doppler Sonography
The following diagnosis codes may be reimbursed when submitted with Peripheral Arterial Doppler Studies lower extremity condition procedure codes 93922, 93923, 93924, 93925, and 93926:
The following diagnosis codes may be reimbursed when submitted with Peripheral Venous Doppler Studies procedure codes 93970 and 93971:Added Diagnosis CodesL97115 L97116 L97118 L97125 L97126 L97128 L97215L97216 L97218 L97225 L97226 L97228 L97315 L97316L97318 L97325 L97326 L97328 L97415 L97416 L97418L97425 L97426 L97428 L97515 L97516 L97518 L97525L97526 L97528 L97815 L97816 L97818 L97825 L97826L97828 L98415 L98416 K98418 L98425 L98426 L98428R0603
Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook, section 9.2.26 “Diagnostic Doppler Sonography,” for more information.
ICD-10 Special Bulletin, No. 12 6 2017 Texas Medicaid
Medicaid Fee-For-Service and Managed Care Providers
CPT only copyright 2016 American Medical Association. All rights reserved.
Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook, section 9.2.25.5 “Echoencephalography,” for more information.
Evoked Response Tests and Neuromuscular Procedures
The following diagnosis codes may be reimbursed when submitted with electromyog-raphy (EMG) and nerve conduction study (NCS) procedure codes:Added Diagnosis CodesE8581 E8582 E8589 G1223 G1224 G1225 M48062Discontinued Diagnosis CodesE858 M4806
Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook, section 9.2.27.2 “Electromyography and Nerve Conduction Studies,” for more information.
Inpatient and Outpatient Behavioral Health
The following diagnosis codes may be reimbursed for psychotherapy and psychiatric diagnostic evaluation procedure codes 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90846, 90847, and 90853:Added Diagnosis CodesF1011 F1111 F1211 F1311 F1411 F1511 F1611F1811 F1911 F5082
ICD-10 Special Bulletin, No. 12 7 2017 Texas Medicaid
Medicaid Fee-For-Service and Managed Care Providers
CPT only copyright 2016 American Medical Association. All rights reserved.
The following diagnosis codes may be reimbursed for psychological, neurological, and neuropsychological testing procedure codes 96101, 96116, and 96118:Added Diagnosis CodesF1011 F1111 F1211 F1311 F1411 F1511 F1611F1811 F1911 F5082Discontinued Diagnosis CodesS065X7D S065X7S S065X8D S065X8S S06897D S06897S
Refer to: The current Texas Medicaid Provider Procedures Manual, Behavioral Health and Case Management Services Handbook, section 4.1.12 “Services, Benefits, and Limitations,” for more information.
Mental Health Rehabilitative Services
The following diagnosis code may be reimbursed when submitted with mental health rehabilitative services procedure codes H0034, H2012, H2014, and H2017:Added Diagnosis CodeF5082
Refer to: The current Texas Medicaid Provider Procedures Manual, Behavioral Health and Case Management Services Handbook, section 5.2.3 “Mental Health Rehabili-tative Services,” for more information.
Mental Health Targeted Case Management
The following diagnosis code may be reimbursed when submitted with mental health targeted case management procedure code T1017:Added Diagnosis CodeF5082
Refer to: The current Texas Medicaid Provider Procedures Manual, Behavioral Health and Case Management Services Handbook, section 5.2.2 “Mental Health Targeted Case Management (MHTCM),” for more information.
Physician Evaluation and Management Services
The following diagnosis code may be reimbursed when submitted with procedure code 99078:Added Diagnosis CodeE1110
Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook, section 9.2.56 “Physician Evaluation and Management (E/M) Services,” for more information.
ICD-10 Special Bulletin, No. 12 8 2017 Texas Medicaid
Medicaid Fee-For-Service and Managed Care Providers
CPT only copyright 2016 American Medical Association. All rights reserved.
Pulmonary Function Studies
The following diagnosis codes may be reimbursed for High Altitude Simulation Test (HAST) procedure codes 94452 and 94453:Added Diagnosis CodesI2720 I2721 I2722 I2723 I2724 I2729 I2783Discontinued Diagnosis CodeI272
Evidence of hypoxemia must be documented in the client’s medical record when billing HAST procedure codes 94452 and 94453 with one of the following diagnosis codes:Added Diagnosis CodesI2720 I2721 I2722 I2724 I2729 I2783Discontinued Diagnosis CodeI272
Refer to: The current Texas Medicaid Provider Procedures Manual, Inpatient and Outpa-tient Hospital Handbook, section 4.2.20.4 “Pulmonary Function Studies,” for more information.
Substance Use Disorder Services
The following diagnosis codes may be reimbursed when submitted with ambulatory (outpatient) treatment services procedure codes H0004 and H0005:
Refer to: The current Texas Medicaid Provider Procedures Manual, Behavioral Health and Case Management Services Handbook, section 8, “Substance Use Disorder (SUD) Services (Abuse and Dependence),” for more information.
Vision Services – Nonsurgical
The following diagnosis codes may be reimbursed when submitted with polycarbonate lens procedure code V2784:Added Diagnosis CodesH540X33 H540X34 H540X35 H540X43 H540X44 H540X45 H540X53H540X54 H541131 H541132 H541141 H541142 H541151 H541152H541213 H541214 H541215 H541223 H541224 H541225 H542X12H542X21 H542X22 H54413A H54414A H5442A3 H5442A4 H54512AH5452A2
ICD-10 Special Bulletin, No. 12 9 2017 Texas Medicaid
Medicaid Fee-For-Service and Managed Care Providers
CPT only copyright 2016 American Medical Association. All rights reserved.
Refer to: The current Texas Medicaid Provider Procedures Manual, Vision and Hearing Services Handbook, section 4.3.6.1 “Eyeglass Lens and Frames,” for more information.
Vitamin B12 (Cyanocobalamin) Injections
The following diagnosis code will no longer be covered for Vitamin B12 (Cyanocobalamin) Injections procedure code J3420: Discontinued Diagnosis CodeK5660
Refer to: The current Texas Medicaid Provider Procedures Manual, Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook, section 9.2.38.35 “Vitamin B12 (Cyanocobalamin) Injections,” for more information.
HOME HEALTH AND COMPREHENSIVE CARE PROGRAM (CCP) PROVIDERS
Home Health Services Benefit ChangesThe following Texas Medicaid Home Health Services benefit changes have been made to support the 2018 International Classification of Diseases (ICD) updates and are effective for dates of service on or after October 1, 2017. For more information, call the Texas Medicaid & Healthcare Partnership (TMHP) Contact Center at 1-800-925-9126.
Diabetic Equipment and Supplies Home Health
The following diagnosis code may be reimbursed without prior authorization when submitted with blood testing and supplies procedure codes to home health durable medical equipment (DME) and medical supplier DME providers: Added Diagnosis CodeE1110
Refer to: The current Texas Medicaid Provider Procedures Manual, Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook, section 2.2.11.3 “Glucose Testing Equipment and Other Supplies,” for more information.
ICD-10 Special Bulletin, No. 12 10 2017 Texas Medicaid
Home Health and Comprehensive Care Program (CCP) Providers
CPT only copyright 2016 American Medical Association. All rights reserved.
CCP Services Benefit ChangesThe following Texas Medicaid CCP benefit changes have been made to support the 2018 ICD updates and are effective for dates of service on or after October 1, 2017. For more information, call the TMHP Contact Center at 1-800-925-9126.
Blood Pressure Devices – CCP
The following diagnosis codes may be reimbursed when submitted with manual and automated blood pressure devices procedure codes A4660 and A4670:Added Diagnosis CodesI219 I21A1 I21A9 I2720 I2721 I2722 I2723I2724 I2729 I2783 I50810 I50811 I50812 I50813I50814 I5082 I5083 I5084 I5089
Refer to: The current Texas Medicaid Provider Procedures Manual, Children’s Services Handbook, section 2.6.4.1.1 “Manual and Automated Blood Pressure Devices,” for more information.
Nutritional Products - CCP
Nutritional products may be reimbursed without prior authorization when they are submitted with the following diagnosis codes:Added Diagnosis CodesE8581 E8589Discontinued Diagnosis CodeE858
Refer to: The current Texas Medicaid Provider Procedures Manual, Children’s Services Handbook, section 2.7.10, “Nutritional Products,” for more information.
ICD-10 Special Bulletin, No. 12 11 2017 Texas Medicaid
Home Health and Comprehensive Care Program (CCP) Providers
CPT only copyright 2016 American Medical Association. All rights reserved.
CHILDREN WITH SPECIAL HEALTH CARE NEEDS (CSHCN) SERVICES PROGRAM PROVIDERS
CSHCN Services Program UpdatesThe 2018 ICD updates for the CSHCN Services Program are included in the ICD tables in the “All Code Changes: Added, Revised, and Discontinued” section of this bulletin beginning on page 16. The 2018 ICD deletions are effective October 1, 2017, for dates of service on or after October 1, 2017, for the CSHCN Services Program. Providers may refer to the “General Information” section for more information.
CSHCN Services Program Benefit ChangesThe following CSHCN Services Program benefit changes have been made to support the 2018 ICD updates and are effective for dates of service on or after October 1, 2017. For more information, call the TMHP-CSHCN Services Program Contact Center at 1-800-925-9126.
The policy articles below contain the following information:
• Revised: The description has been revised for these diagnosis codes. Providers may refer to the appropriate copyright holder for the revised descriptions.
• Discontinued: Discontinued diagnosis codes are no longer reimbursed after September 30, 2017.
• Added: Added diagnosis codes are new procedure codes added by the Centers for Medicare & Medicaid Services (CMS).
Ambulance Services
The following emergency medical condition codes must be used to identify emergency medical conditions for ambulance transports:Added Diagnosis CodesR0603 T07XXXA T148XXA T1490XA T1491XADiscontinued Diagnosis CodesT07 T148
An emergency ambulance transport may be reimbursed by the CSHCN Services Program when it is submitted with modifier ET and one or more emergency medical condition codes.
The requesting facility or physician must include with the claim documentation that describes the clients’ condition which necessitated the ambulance transport. Medicaid recognizes limitations of usual ambulance personnel for establishing a diagnosis, and recognizes coding of a client’s condition using International Classification of Diseases,
ICD-10 Special Bulletin, No. 12 12 2017 Texas Medicaid
Children With Special Health Care Needs (CSHCN) Services Program Providers
CPT only copyright 2016 American Medical Association. All rights reserved.
10th Revision, Clinical Modification (ICD-10-CM) when reporting ambulance transport services may be less specific than for services reported by other professional providers.
Providers who submit ICD-10-CM diagnosis codes should choose the code that best describes the client’s condition at the time of transport. Diagnoses that are “rule out” or “suspected” diagnoses should not be reported using specific ICD-10-CM diagnosis codes. In such instances where a diagnosis is not confirmed, it is more correct to use a symptom, finding, or injury diagnosis code.
Refer to: The current CSHCN Services Program Provider Manual, section 9.3, “Emergency Ambulance Transports,” for more information.
Ambulatory Blood Pressure Monitoring and Devices
The following diagnosis codes may be reimbursed when submitted with procedure codes A4660 and A4670:Added Diagnosis CodesI219 I21A1 I21A9 I2720 I2721 I2722 I2723I2724 I2729 I2783 I50810 I50811 I50812 I50813I50814 I5082 I5083 I5084 I5089Revised Diagnosis CodeI501
Refer to: The current CSHCN Services Program Provider Manual, section 11.2.1.2 “Manual and Automated Blood Pressure Devices,” for more information.
Cytogenetics
The following diagnosis codes may be reimbursed when submitted with procedure codes 88230, 88233, 88235, 88237, 88239, 88245, 88248, 88249, 88261, 88262, 88263, 88264, 88271, 88272, 88273, 88274, 88275, 88280, 88283, 88285, 88289, and 88291:Added Diagnosis CodesP2930 P2938 Q53111 Q53112 Q5313 Q53211 Q53212Q5323Discontinued Diagnosis CodesP293 Q5311 Q5321Revised Diagnosis CodesQ6412 Q822 Z315
Refer to: The current CSHCN Services Program Provider Manual, section 25.2.5.2 “Cytogenetics Testing,” for more information.
ICD-10 Special Bulletin, No. 12 13 2017 Texas Medicaid
Children With Special Health Care Needs (CSHCN) Services Program Providers
CPT only copyright 2016 American Medical Association. All rights reserved.
Diabetic Equipment and Supplies
The following diagnosis codes may be reimbursed without prior authorization when submitted with blood testing and supplies procedure codes:Added Diagnosis CodeE1110
Refer to: The current CSHCN Services Program Provider Manual, section 15.2.1 “Glucose Monitor and Supplies,” for more information.
Refer to: The current CSHCN Services Program Provider Manual, section 31.2.17 “Echoencephalography,” for more information.
Evoked Response and Neuromuscular Procedures
The following diagnosis codes may be reimbursed when submitted with electromyog-raphy (EMG) and nerve conduction study (NCS) procedure codes:Added Diagnosis CodesE8581 E8582 E8589 G1223 G1224 G1225 M48062Discontinued Diagnosis CodesE858 M4806Revised Diagnosis CodesM3300 M3301 M3302 M3309 M3310 M3311 M3312M3319
ICD-10 Special Bulletin, No. 12 14 2017 Texas Medicaid
Children With Special Health Care Needs (CSHCN) Services Program Providers
CPT only copyright 2016 American Medical Association. All rights reserved.
Refer to: The current CSHCN Services Program Provider Manual, section 31.2.19 “Evoked Response and Neuromuscular Procedures,” for more information.
Expendable Medical Supplies
The following diagnosis codes may be reimbursed when submitted with the appropriate diapers, briefs, pull-ups, or liners procedure codes:Revised Diagnosis CodesN35112 N35113 N35114 N99111 N99112 N99113 Q6412
Refer to: The current CSHCN Services Program Provider Manual, section 18.2.4 “Diapers, Briefs, Pull-ups, and Liners,” for more information.
Neurostimulators and Neuromuscular Stimulators
The following diagnosis codes may be considered for prior authorization when submitted with appropriate dorsal column neurostimulation (DCN), intracranial neurostimulation (ICN), or percutaneous electrical nerve stimulation (PENS) device procedure codes:Added Diagnosis CodesG1223 G1224 G1225 M48061 M48062Discontinued Diagnosis CodeM4806
Refer to: The current CSHCN Services Program Provider Manual, section 27.2.1 “Dorsal Column Neurostimulation (DCN),” section 27.2.2 “Intracranial Neurostimu-lation (ICN),” and section 27.2.4 “Percutaneous Electrical Nerve Stimulation (PENS),” for more information.
Therapeutic Apheresis
The following diagnosis codes may be reimbursed when submitted with procedure codes 36511, 36512, 36513, 36514, 36515, and 36516:Revised Diagnosis CodesM3300 M3301 M3302 M3309 M3310 M3311 M3312M3319
Refer to: The current CSHCN Services Program Provider Manual section 31.2.40 “Thera-peutic Apheresis,” for more information.
ICD-10 Special Bulletin, No. 12 15 2017 Texas Medicaid
Children With Special Health Care Needs (CSHCN) Services Program Providers
CPT only copyright 2016 American Medical Association. All rights reserved.
Vision Services Nonsurgical
The following diagnosis codes may be reimbursed when submitted with the appropriate contact lenses and their prescription and fitting procedure codes:Added Diagnosis CodesH442A1 H442A2 H442A3 H442A9 H442B1 H442B2 H442B3H442B9 H442C1 H442C2 H442C3 H442C9 H442D1 H442D2H442D3 H442D9 H442E1 H442E2 H442E3 H442E9
Refer to: The current CSHCN Services Program Provider Manual, section 40.2.1.4 “Contact Lenses,” for more information.
ALL CODE CHANGES: ADDED, REVISED, AND DISCONTINUED
For more information, call the Texas Medicaid & Healthcare Partnership (TMHP) Contact Center at 1-800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 1-800-568-2413.
ICD-10 Special Bulletin, No. 12 17 2017 Texas Medicaid
All Code Changes: Added, Revised, and Discontinued
CPT only copyright 2016 American Medical Association. All rights reserved.
Discontinued Diagnosis CodesThe 2018 ICD discontinued diagnosis codes are no longer valid for claims submitted with dates of service on or after October 1, 2017. The following is a list of diagnosis codes that have been discontinued: Diagnosis CodesA047 C962 D470 E858 H540 H5411 H5412H542 H5441 H5442 H5451 H5452 I272 K060K565 K5660 K5669 K913 M4806 N63 O0010O0011 O0020 O0021 P293 P838 P918 Q5311Q5321 S061X7D S061X7S S061X8D S061X8S S062X7D S062X7SS062X8D S062X8S S06307D S06307S S06308D S06308S S06317DS06317S S06318D S06318S S06327D S06327S S06328D S06328SS06337D S06337S S06338D S06338S S06347D S06347S S06348DS06348S S06357D S06357S S06358D S06358S S06367D S06367SS06368D S06368S S06377D S06377S S06378D S06378S S06387DS06387S S06388D S06388S S064X7D S064X7S S064X8D S064X8SS065X7D S065X7S S065X8D S065X8S S066X7D S066X7S S066X8DS066X8S S06817D S06817S S06818D S06818S S06827D S06827SS06828D S06828S S06897D S06897S S06898D S06898S S069X7DS069X7S S069X8D S069X8S S63131A S63131D S63131S S63132AS63132D S63132S S63133A S63133D S63133S S63134A S63134DS63134S S63135A S63135D S63135S S63136A S63136D S63136SS63141A S63141D S63141S S63142A S63142D S63142S S63143AS63143D S63143S S63144A S63144D S63144S S63145A S63145DS63145S S63146A S63146D S63146S T07 T148 T1490T1491 Z36
For more information, call the TMHP Contact Center at 1-800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 1-800-568-2413.
Diagnosis Code Description ChangesEffective for dates of service on or after October 1, 2017, the following diagnosis code descriptions have changed:Diagnosis CodesF410 H02051 H02052 H02053 H02054 H02055 H02056H02059 I501 I63211 I63212 I6322 I63323 I63333I63513 I63523 I63533 I82811 I82812 I82819 I83811
ICD-10 Special Bulletin, No. 12 18 2017 Texas Medicaid
All Code Changes: Added, Revised, and Discontinued
CPT only copyright 2016 American Medical Association. All rights reserved.
For more information, call the TMHP Contact Center at 1-800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 1-800-568-2413.
ICD-10 Special Bulletin, No. 12 19 2017 Texas Medicaid
All Code Changes: Added, Revised, and Discontinued
CPT only copyright 2016 American Medical Association. All rights reserved.
INPATIENT HOSPITAL ICD-10-PCS AND DRG
Inpatient Hospital ICD-10-PCS Surgical Procedure Code and Diagnosis Related Group (DRG) UpdatesThe ICD-10-PCS procedure codes are inpatient hospital surgical procedure codes and must be submitted, as applicable, only on inpatient hospital claims.
Note: For professional and outpatient procedures and services, providers must continue to use the American Medical Association (AMA) Current Procedural Terminology (CPT) manual and the CMS Health Care Common Procedure Coding System (HCPCS) manual.
This section lists the ICD-10-PCS inpatient hospital surgical procedure code changes for inpatient hospital providers. Providers should refer to the appropriate copyright holder’s code listing for the new, discontinued, and revised descriptions for the procedure codes indicated below. All discontinued codes will not be reimbursed for dates of service on or after October 1, 2017.
The following table lists all of the new surgical procedure codes: