MultiPlan's Approach to ICD-10 Remediation
Since the October 1, 2015 compliance date, MultiPlan has been successfully processing claims with ICD-10 codes. When repricing these claims, we do not crosswalk inbound claims with ICD-9 codes to ICD-10 or vice versa. Instead, we have made changes to our systems and processes that enable us to reprice each claim based on the code with which it is submitted, making our ICD-9/ICD-10 repricing dependent on the claim data clients send us.
The difficulty arises because there are often not one-to-one exact or even approximate matches in the translations from ICD-9 codes to ICD-10. In these cases, our translations from ICD-9 to ICD-10 and vice versa are based on CMS's general equivalence mappings (GEMs). Because GEMS leaves room for interpretation, we have posted the maps we use below.
To help you find the codes you are searching for, we segmented our lists of ICD-9 diagnosis and procedures codes according to how they are presented in CMS's book of ICD-9 codes. Please note the lowercase v followed by a letter at the end of the code names indicates the version of the file and is for MultiPlan use only. Our mapping spreadsheets will be updated on a yearly basis (or as specified by CMS).
You can learn more about our remediation approach here.