DMERCs: New ICD-9 codes will be no nightmare

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Monday, March 31, 2003

BALTIMORE - Allaying fears of an operational nightmare, the DMERCs are publishing bulletins asserting that HME providers will not have to obtain new CMNs even if the ICD-9 codes are not valid for the date of service on the claim or not at the highest level of specificity.

Starting April 1, diagnosis codes must be valid for the date of service and must be current to the highest level of specificity. For example, the ICD-9 codes describing diabetes mellitus (250.00-250.93) require 5 digits. The 3 digit code (250) and the 4 digit codes (for example, 250.0, 250.1, etc.) in this range are not acceptable for claim submission.

Although providers do not reconcile ICD-9 codes on existing CMNs, the DMERCS insist that the codes on the claims be valid for the date of service to the highest level of specificity.

“Once a CMN has been accepted into the DMERC system, there is no requirement to update the ICD-9 diagnosis code on the CMN if there is no other need to revise the CMN,” Region D wrote in its bulletin.

“The only requirement is that a valid ICD-9 diagnosis code be submitted on each claim.” HME

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