ICD-10 Qualifiers
It should be remembered while submitting claims that the appropriate ICD-10 Qualifiers or ICD-9 qualifiers must be used:
- ICD-10 qualifiers must be used for claims with ICD-10 diagnosis codes; applicable to all claims for services on or after October 1, 2015.
- ICD-9 qualifiers must be used for claims with ICD-9 diagnosis codes; applicable to only claims for services before October 1, 2015.
How to Use ICD-10 Qualifiers
The ICD-10 qualifiers should be used as follows :
- 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.