This page will walk the user through how to set the ICD preference per claim.
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What it Means
Setting ICD preferences per claim will allow the user to determine if a claim should be sent with ICD-9 codes or ICD-10 codes on the claim. This is especially important for re-billing claims that were originally sent prior to the October 1st date for ICD-10. The following guide will explain where to find this, how to change it, and the logic behind this setting.
Where
This setting can be found inside of an Encounter, on the Invoice tab > Claim Details. On claim details you will see two radio buttons at the top of the screen, called Code Format, that will list ICD-9 or ICD-10.
To switch between ICD-9 or ICD-10, simply click the radio button for the code format you need to send.
How it Works
The ICD-9 and ICD-10 code format buttons will default following the below logic:
- If the Note Date is prior to 10/1/2015, this setting will always be send to ICD-9.
- Note that this is regardless of the Insurance setting.
- If the Note Date is after 10/1/2015, then:
- The system will check the Primary Insurance for the Send ICD-10 setting. If True, the encounter will be set to ICD-10. If False, the encounter will be set to ICD-9.
- If there is no insurance present, it will be set to ICD-10.
Note:
- Regardless of the defaults, the user can always override this setting by manually clicking the appropriate radio button.
- When changing the primary insurance on an encounter, TRAKnet will compare the encounter settings to the primary insurance. If they do not match, it will ask the user if they would like to change this setting to match the insurance's setting.
Confirming What is Sent
To confirm which code format will be sent, ICD-9 or ICD-10, from the Invoice > Claim Details tab, click either: ANSI 837 Preview of CMS 1500 Preview.
In ANSI, this information is in: 2300 Claim Information > 2300 Claim Information > Health Care Information Codes (HI).
On the CMS 1500 this information goes in Box 21.
Additional Pages
Turning On ICD-10
ICD-10 Testing
Bulk Setting Code Format per Insurance