Medicare uses external cause codes to determine COB information. Medicare will no longer accept these codes after January 2017. The following ICD-10-CM Diagnosis Codes will be added to the list of excluded ICD-10-CM external injury diagnosis codes:
- T88.7XXA (Unspecified adverse effect of drug or medicament, initial encounter)
- T88.7XXD (Unspecified adverse effect of drug or medicament, subsequent encounter)
- T88.7XXS (Unspecified adverse effect of drug or medicament, sequela)
- T88.8XXA (Other specified complications of surgical and medical care, not elsewhere classified, initial encounter)
- T88.8XXD (Other specified complications of surgical and medical care, not elsewhere classified, subsequent encounter)
- T88.8XXS (Other specified complications of surgical and medical care, not elsewhere classified, sequel)
- T88.9XXA (Complication of surgical and medical care, unspecified, initial encounter)
- T88.9XXD (Complication of surgical and medical care, unspecified, subsequent encounter)
- T88.9XXS (Complication of surgical and medical care, unspecified, sequel)
These codes will not be accepted in the Alleged Cause of Injury, Incident or Illness (Field 15) or in any ICD Diagnosis Code field starting with Field 18. Updates to previously submitted records using these excluded codes also will be rejected.
CMS will continue to accept these codes on claims submitted before January 2, 2017, however it’s important to be aware that they will cause an SP disposition code with an error attached to the ICD position in which they were reported after that date.
Errors also will be returned on claims that were previously submitted and accepted by CMS with these ICD codes if an update is submitted to CMS on or after January 2, 2017.