Enter ICD-10 codes in e-referral for dates of service October 1 or later

A federal mandate requires all HIPAA-covered entities to adopt ICD-10 by Oct. 1, 2015. The International Classification of Diseases, 10th revision, Clinical Modification (ICD-10-CM) and Procedure Coding System (ICD-10-PCS) are new medical code sets under the Health Insurance Portability and Accountability Act and represent a significant change to the current ICD-9 coding system.

Providers should be aware of the following when entering referrals and authorizations into e-referral:

• Authorizations and referrals submitted into e-referral with an ICD-9 code prior to October 1 with a date of service that spans past October 1 will not need to be resubmitted with an ICD-10 code.


• Authorizations and referrals submitted into e-referral for dates of service October 1 and later should include an ICD-10 code.


• Authorizations and referrals submitted into e-referral for dates of service October 1 and later with an ICD-9 code will see the warning message: "You have selected an inactive (retired) code. Would you like to continue?" Please choose No and select an ICD-10 code.


• If you are using e-referral bookmarks that contain an ICD-9 code, you will not see the warning message. Please delete any ICD-9 codes from your bookmarks.