While almost all 50 states will be making the federally mandated conversion to ICD-10 codes on the official Oct. 1 deadline, four states will not be following suit.

4 states receive ICD-10 deadline extension

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While almost all 50 states will be making the federally mandated conversion to ICD-10 codes on the official Oct. 1 deadline, four states will not be following suit. Louisiana, Maryland, California and Montana have been granted a clearance from the Centers for Medicare & Medicaid Services to continue using ICD-9 codes, according to Modern Healthcare.

Unable to adapt
Claims systems in these four states have been unable to perform proper payment calculations or process new ICD-10 codes without additional assistance. The CMS spent the last several months stressing the necessity of testing before the official deadline, and the inability for these states' systems to comply with the new codes is a perfect example of its importance. While Medicaid fee-for-service programs in the rest of the nation will be converting at the end of the month, the CMS has agreed that it would not be feasible for Louisiana, Maryland, California and Montana to proceed with the diagnosis code transition.

"We have worked closely with each state to understand how they will mitigate any issues that may arise and minimize impact on the accuracy and timeliness of provider payments," said Jibril Boykin, spokesman for the CMS, confirming the agency's approval of the clearance for these four states.

Temporary solution
In a short-term fix, a "crosswalk" technique has been implemented, allowing incoming ICD-10 codes to be converted back to ICD-9 codes, according to Modern Healthcare. These crosswalks exist as a text file on a computer with the capability to map code from ICD-10 to ICD-9 or vice versa. Those exempt will also be allowed to continue to use the older systems to make payments for health care providers.

Many experts and providers have warned about the likely potential for glitches with this back-and-forth process. Concerns for delays, rejections and the transparency of the crosswalk method have all been voiced by hospitals and providers alike. These concerns have all been met with a statement from the CMS that the crosswalk approach is only temporary.

With this newly granted exemption, the primary concern that has been the root cause of worry for everyone throughout the entire transition process is now coming to life. According to Medicaid, there is no clear mapping from the previous set of codes to the new ICD-10 codes, even though that it was what the crosswalk system was created to do. It may seem like a no-brainer, yet there are some codes that do correspond one-to-one. However, the majority of the 68,000 new codes have no direct translation to the previous 13,000 codes and many professionals are worried that crosswalking is not the most effective method.

According to McKnight's Long-Term Care News Magazine, Louisiana, Maryland, California and Montana are all eventually anticipated to secure claims systems that can directly handle the new ICD-10 coding. California has already begun work on a replacement claims system. In the meantime, the state has implemented a crosswalk system that exemplified success with its ability to minimize the chances for payment variations between the two sets of codes. Additionally, this method reduced the risks and impact on providers. The hope is to get all four states back on track in a timely manner.