CMS Updates
Details

ICD-10 News: Qualifiers for ICD-10 Diagnosis Codes on Electronic Claims


As you submit electronic claims for services, remember that:

  • Claims with ICD-10 diagnosis codes must use ICD-10 qualifiers; all claims for services on or after October 1, 2015, must use ICD-10
  • Claims with ICD-9 diagnosis codes must use ICD-9 qualifiers; only claims for services before October 1, 2015, can use ICD-9

How to Use ICD-10 Qualifiers

Use ICD-10 qualifiers as follows (FAQ 12889):

  • For X12 837P 5010A1 claims, the HI01-1 field for the Code List Qualifier Code must contain the code “ABK” to indicate the principal ICD-10 diagnosis code being sent. When sending more than one diagnosis code, use the qualifier code “ABF” for the Code List Qualifier Code to indicate up to 11 additional ICD-10 diagnosis codes that are sent.
  • For X12 837I 5010A1 claims, the HI01-1 field for the Principal Diagnosis Code List Qualifier Code must contain the code “ABK” to indicate the principal ICD-10 diagnosis code being sent. When sending more than one diagnosis code, use the qualifier code “ABF” for each Other Diagnosis Code to indicate up to 24 additional ICD-10 diagnosis codes that are sent.
  • For NCPDP D.0 claims, in the 492.WE field for the Diagnosis Code Qualifier, use the code “02” to indicate an ICD-10 diagnosis code is being sent.

Real Physicians, Real Results

Discover how physician groups thrive with us

Help Us Understand Your Requirements

Get in touch with us for more Information.
We're ready to assist with your billing and coding needs.

Name (*Required )
Phone Number (*Required )
State
Speciality
Email
Monthly Insurance Collection
Requirement & Preferred Time to Call

Are you looking for more than one billing quotes ?