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Coming October 1, 2024, ICD-10 Annual Updates

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Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.

On October 1, 2024, the Texas Medicaid & Healthcare Partnership (TMHP) will implement the International Classification of Diseases, Tenth Revision (ICD-10) changes that are effective for dates of service on or after October 1, 2024. The update includes changes to the Clinical Modification (ICD-10-CM) diagnosis code and the Procedure Coding System (ICD-10-PCS) surgical procedure code.

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.