The purpose of this information letter (IL) is to provide information and guidance to Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID) providers and Local Intellectual and Developmental Disability Authorities (LIDDAs) about the International Classification of Disease (ICD) transition from Version 9 (ICD-9) to Version 10 (ICD-10) and associated changes for submitting diagnosis codes on the Department of Aging and Disability Services (DADS) Form 8578, Intellectual Disability/Related Conditions (ID/RC) Assessment.
The Centers for Medicare and Medicaid Services (CMS) will require healthcare providers and governmental entities to transition from ICD-9 to ICD-10 effective October 1, 2015. To ensure there is no lapse in the program eligibility for an individual receiving services in an ICF/IID because of the transition from ICD-9 to ICD-10, an ICF/IID provider and LIDDA must comply with the following:
All ID/RC Assessments with effective dates prior to October 1, 2015, must be submitted using ICD-9 diagnostic codes.
All ID/RC Assessments with effective dates of October 1, 2015, or later must be submitted using ICD-10 diagnostic codes.
Due to system changes for accepting ICD-10 diagnostic codes, ICF/IID providers and LIDDAs must not enter ID/RCs with an effective date on or after October 1, 2015, into the Texas Medicaid and Healthcare Partnership (TMHP) provider portal until August 28, 2015 or later.
For new enrollments (Purpose Code 2), ID/RCs entered on or after Oct. 1, 2015, with a requested effective date prior to October 1, 2015, LIDDAs must enter the ID/RC into the TMHP provider portal and add a notation in the Review Tab for DADS Utilization Management and Review to backdate the form and include the ICD-9 code in the notation. The LIDDA must give the ICF/IID provider a copy of the ID/RC Assessment forms.
One form must include an individual’s ICD-9 diagnostic code and one form must include the individual’s ICD- 10 diagnostic code, each attested to by a physician.
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