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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.

Diagnosis Codes
CM_001_049_vA
CM_050_139
CM_140_199_vA
CM_200_239_vA
CM_240_279_COMBO_vA
CM_280_289_vA
CM_290_319_COMBO_vE
CM_320_359_vB
CM_360_372_vC
CM_373_389_vA
CM_390_459_vB
CM_460_519_vB
CM_520_579_COMBO_vA
CM_580_629_vA
CM_630_649_vB
CM_650_679_vA
CM_680_709_vB
CM_710_719_vA
CM_720_739_vB
CM_740_759_COMBO_vA
CM_760_779
CM_780_799_vA
CM_800_829_COMBO_vA
CM_830_899_COMBO_vB
CM_900_949_vA
CM_950_999_vD
CM_E000_E799
CM_E800_E899
CM_E900_E999_COMBO_vA
CM_V01_V39_vB
CM_V40_V91_vB
CM_V58.89_vA

Procedure Codes
PCS_00_COMBO_vC
PCS_01_05_COMBO_vA
PCS_06_07
PCS_08_16_COMBO_vA
PCS_17_COMBO
PCS_18_20
PCS_21_29_COMBO
PCS_30_34_COMBO_vA
PCS_35_39_COMBO_vD
PCS_40_41_COMBO
PCS_42_54_COMBO_vA
PCS_55_59_COMBO
PCS_60_64_COMBO_vA
PCS_65_71_COMBO_vA
PCS_72_75_COMBO_vA
PCS_76_84_COMBO_vC
PCS_85_86_COMBO_vC
PCS_87_92_vB
PCS_93_99_COMBO_vB