Content updated May 27, 2016
Calling PAC with ICD-10-Related Issues
REMINDER: Bill ICD-10 Diagnosis Codes Without Decimals
Billing ICD-10 Codes with PES
Claims Submitted Without ICD-10 Codes On or After 10/1/15 Will NOT Be Paid
In order to expedite your wait time, please have the following information ready when you call:
- MC0* Submitter ID
- Rejection Codes (Edit numbers and EOB numbers)
- ICN (for paper claims)
- Batch number
- Recipient ID number
- Patient account number
Before you call, review the ICD-10 Billing and Compliance Tips (Word, new window) and FAQ below that might help you resolve your issue and avoid the call center. The answer you need may already be online.
Please remember to omit decimals in all ICD-9 and ICD-10 codes when submitting claims for payment. For example, diagnosis code E119.5 should be entered as E1195. This is not a new requirement. Decimals have not been allowed in ICD-9 codes and they are not allowed in ICD-10 codes.
To submit claims with ICD-10 codes using PES, you must upgrade to PES 2.23 or greater. You will need to install PES 2.24 (the current version) to submit Alternative Benefit Plan claims.
Bug fixes and system changes that necessitate a new PES release may cause issues with older versions of PES software. Upgrading as soon as possible after a new release of PES is available is highly recommended to avoid crashes and losing data. Waiting too long to upgrade your software may cause your system to crash when you must upgrade more than one version to get current. Upgrades should be applied sequentially. Skipping versions when upgrading increases the likelihood of system crashes.
Claims submitted without ICD-10 codes for dates of service or dates of discharge on or after 10/1/15 will NOT be paid. Upgrade to PES 2.24 today.
All claims submitted to Arkansas Medicaid for Dates of Service on and after 10/1/15 must bill using ICD-10 codes. Claims that do not bill ICD-10 codes will deny and you will not be paid by Arkansas Medicaid. This is a Federal mandate. Feel free to contact Arkansas Medicaid for assistance. With more than 38,000 providers, we expect a high volume of inquiries and possible delays in responses. We appreciate your patience.
Answers to Arkansas Medicaid providers’ most frequent ICD-10 questions posted here may help save you time. Review the FAQ before calling the Provider Assistance Center with your questions about ICD-10.
What if my bill dates are before 10/1/2015?
If you are billing dates of service before 10/1/2015, you must use ICD-9 codes.
Where can I find ICD-10 codes?
A crosswalk from ICD-9 to ICD-10 will NOT be provided. The ICD codes have been removed from the provider manuals and DMS forms and replaced with a hyperlink to a corresponding Excel spreadsheet where there is a tab for ICD-9 codes and a tab for the ICD-10 codes. You should also purchase the ICD-10 book to find codes.
I need assistance with a code translation from ICD-9 to ICD-10. Where can I find a list of code translations? Will you be able to help me find new codes if they deny?
DXC Technology and DMS are unable to provide code translations. Code assignment is based on documentation contained with the patient’s medical record. Code translation resources can be found at:
Why can’t I enter ICD-10 codes using PES?
To submit claims with ICD-10 codes using PES, you must upgrade to PES 2.23 or greater. You must upgrade your software in sequential order; each lower version must be upgraded before you can upgrade to the next version. If you are currently using version 2.20, you MUST upgrade to 2.21, then 2.22, then 2.23. View or print PES upgrade instructions or download the upgrade now.
Dates of service on and after 10/1/2015 must be entered using ICD-10 codes.
How do I file ICD-10 codes on paper claim forms?
The paper claim instructions have been updated for ICD-9 and ICD-10 in the Arkansas Medicaid provider manuals. The manuals also indicate the appropriate claim forms. Provider manuals are available on the Arkansas Medicaid website at https://www.medicaid.state.ar.us/Provider/docs/docs.aspx.
Will I get a new submitter ID?
No, a new submitter ID number will not be issued. Please continue to use the provider’s current number.
Do 783 providers have to change anything?
There are new forms for Alternative Care Providers. There is an ICD-9 form and an ICD-10 form. You will need to get those from your Case Manager. You will submit the ICD-9 form for dates of service before 10/1/2015. You will submit the ICD-10 form for dates of service on or after 10/1/2015. If you are an Environmental Provider and bill using form CMS-1500, then you will need to start using ICD-10 codes with dates of service on or after 10/1/2015.
Alternative care providers billing Z73.6 for the ICD-10 claim form must NOT include the period (.) when entering the claim. Enter Z736 on the ICD-10 claim form - with NO period (.) - or the claim will deny.
How will the ICD-10 transition/conversion affect my dental practice?
Dental providers are not impacted by the conversion to ICD-10 since Arkansas Medicaid does not require diagnosis codes for dental claims submission (electronic or paper claim form ADA J430).
CMS and the AMA have approved a grace period for submission of ICD-10 codes. Why isn’t Arkansas Medicaid allowing the same grace period?
The guidelines issued by CMS and the AMA are only applicable for Medicare Part B, Fee for Service claims. They do not apply to Medicaid claims. The other components of the guidelines apply to submission of data for the Physician Quality Reporting System (RQRS) and Meaningful Use Attestation Data. These components are relevant to Medicare Only. All claims for dates of service on or after 10/1/2015 must be submitted using ICD-10 codes. This applies to Medicare, Medicaid, and commercial insurance claims. Additional information can be found on the CMS website.
There are 4 states that aren’t transitioning to ICD-10. Why aren’t they required to begin using ICD-10 on October 1, 2015?
California, Louisiana, Maryland, and Montana have been approved by CMS to “crosswalk” claims that are submitted with ICD-10 codes back to ICD-9 codes so the claim can be processed. This is because the claims processing systems in those four states are unable to perform calculations using the new ICD-10 codes. It is unclear how long each of these four states will be allowed to continue this process since each state’s resolution timeframe is different according to CMS. The claims processing system in Arkansas has been updated to allow for submission of the longer, alphanumeric ICD-10 codes.
I am a Louisiana provider and not yet required to convert to ICD-10. How can I submit claims to Arkansas now?
For dates of service before 10/1/2015, continue to submit your claims to Arkansas Medicaid as you always have.
For dates of service on or after 10/1/2015, you must submit claims to Arkansas Medicaid using ICD-10 codes. If you use Arkansas Medicaid’s PES software and have PES version 2.23 or greater, you may continue to submit claims electronically through this system. If you use Louisiana’s system or any other electronic claim delivery system, then you must submit your claims to Arkansas Medicaid on paper.