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Heading: Providers Code Updates
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 Code Updates Home Page

The procedure and diagnosis codes that are used on claims evolve over time as new codes are added and existing codes are redefined or deleted. The buttons on these pages provide access to the website articles that have been posted about about code updates.

HCPCS

The annual Healthcare Common Procedure Coding System (HCPCS) additions, changes, and deletions are effective for dates of service on or after January 1 each year. Smaller HCPCS updates are implemented quarterly throughout the year.

ICD-10 Code Sets

The International Classification of Diseases, Tenth Revision (ICD-10) procedure code sets are used to report medical diagnoses and inpatient procedures through Health Insurance Portability and Accountability Act (HIPAA) standard transactions.

On October 1 of each year, the Texas Medicaid & Healthcare Partnership (TMHP) applies the International Classification of Diseases, Tenth Revision (ICD-10) additions, changes, and deletions effective for dates of service on or after that date.

NCCI Compliance

The Patient Protection and Affordable Care Act (PPACA) mandates that all claims submitted on or after October 1, 2010, must be filed in accordance with the National Correct Coding Initiative (NCCI) guidelines. NCCI was developed by the Centers for Medicare & Medicaid Services (CMS) to promote the correct coding of health-care services by providers. NCCI consists of pairs of procedure codes that should not be reported together.

 
   
 
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