BACKGROUND IMAGE: iSTOCK/GETTY IMAGES
On Oct. 1, the ICD-10 release date, four state Medicaid programs will not be converting to ICD-10 codes. Instead, they will be allowed to use crosswalks tracing back to ICD-9.
California, Maryland, Montana and Louisiana "are the only states that have programmed the backwards crosswalk into their claims processing systems for their fee-for-service providers," Jibril Boykin, press officer at the Centers for Medicare and Medicaid Services (CMS), said in an email. Every other state and provider, however, is still federally mandated to convert to the code set on the ICD-10 release date.
As for the four state Medicaid programs CMS has allowed to take this crosswalk approach, "they are going to take in a 10 code, they are going to crosswalk it to a 9 code, [and ]adjudicate the claim," said Robert Tennant, director of health information technology policy at the Medical Group Management Association in Englewood, Colo. "So, that means they basically haven't converted to ICD-10." And Tennant said he expects there will be more states that will use this crosswalk approach in the future.
Robert Tennantdirector of health information technology policy, Medical Group Management Association
The California Department of Health Care Services site further explains this crosswalk approach, as it applies to the state's Medi-Cal program:
"The crosswalk will only be used temporarily for ICD-10 claim adjudication while the implementation of our new [Medicaid information] system is being completed," the agency stated. "Once the new system is online, Medi-Cal will adjudicate all claims natively using ICD-10, and the crosswalk will no longer be used."
These waivers confirmed that perhaps the government is not completely ready for the transition, Tennant said. "CMS has stated many times that the Medicaids were ready, and, of course, we're finding out that [they are not]… as we suspected," he added. California serves the largest population of any state, Tennant said.
CMS allowing the four states to use this crosswalk approach will cause a skeptical healthcare community to ask with even more gusto than before: Why does healthcare need to convert to ICD-10?
"If [the crosswalk is] the answer, if they're going to take in a 10 code, crosswalk it back to a 9, the providers are going to say, 'Why the heck are we going through this if all they're doing is essentially adjudicating an ICD-9 code?'" Tennant said.
Learn more about ICD-10:
How ICD-10 codes will affect health IT
ICD-10 late-stage best practices for implementation
Precision required for ICD-10 implementation