ICD-10 and Medicaid Updates

Medicaid Provider Billing Workshops:

Provider billing workshops include both Colorado Medical Assistance Program billing instructions and a review of current billing procedures. Class descriptions and workshop calendars are also posted in the Provider Training section of the Medicaid website.

ICD-10 Updates from Medicaid: 

External end-to-end testing has confirmed that Medicaid's systems are integrated, operable, and ready to accept the new ICD-10 codes and formats on October 1, 2015. Effective October 1, 2015, ICD-10 is now active and replacing ICD-9 diagnosis codes. Providers should note the ICD-10 implementation is Date of Service (DOS) specific:

• ICD-9 diagnosis and surgical procedure codes will be required on claims that contain DOS or dates of discharge (DOD) on or before September 30, 2015.

• ICD-10 diagnosis and surgical procedure codes are required on claims that contain DOS or DOD on or after October 1, 2015.

Claims submitted with both ICD-9 and ICD-10 codes will be rejected.
Medicaid billing manuals have been updated ICD-10 codes. Click here to access the manuals.
Appendix R – Provider Claim Report Denial/Error Codes Update for ICD-10. Click here to find this document under "Appendices" 

Please contact the Department’s fiscal agent, Xerox State Healthcare at 800-237-0757 with billing questions. Please contact Sean Gagnon at Sean.Gagnon@state.co.us or 303-866-3467, or Shawna Tye at Shawna.Tye@state.co.us or 303-866-2347 with questions regarding the ICD-10 implementation project.

HCPF's Provider Bulletin:

Click here to view the October Provider Bulletin. The bulletin covers topics of interest to providers and billing professionals.

HCPF's At a Glance:

Click here to view the September edition of At a Glance. This publication provides information on major initiatives including policy changes and program updates.