ICD-10 and External Cause Codes required

Effective October 1, 2015 Wyoming Medicaid is requiring that providers submit claims with external cause codes for all accident and injury related services. Both professional and institutional claims will be impacted by this policy change. Wyoming Medicaid will not deny claims for one (1) year to allow providers time to transition to billing with external cause codes. Beginning October 1, 2016, if a claim is submitted to Wyoming Medicaid for an accident and/or injury related treatment and an external cause code is not included on the claim, the claim will be denied. This policy change does not impact the current national standard where external cause codes cannot be submitted on a claim as the primary, principle or first-listed diagnosis code. Currently, claims deny if an external cause code is referenced as the first-listed diagnosis code.