ICD-10 Update: Rejected Codes and Formatting Errors

The Virginia Department of Health has asked us to share information related to the October 1 transition to the ICD-10 coding regarding providers’ experience with rejected codes and formatting errors.

If you are experiencing MDS rejections due to ICD-10 coding, for most of these errors, an incorrect ICD-10 code has been used. However, some of the rejected codes are correct, such as I10.  The error message being received is “-3852  Incorrect format:  Invalid ICD-10 item format.”
 
Per the QIES help desk staff, the Centers for Medicare and Medicaid Services (CMS) data edits REQUIRE a decimal place in the fourth field. All codes are LEFT justified, and the fourth field must be a decimal place. So, for any codes which are only 3 digits long, the software should be inserting a “.” into the fourth digit’s space. The remaining empty fields are filled with a ^, which designates a blank space.

Some providers are continuing to see issues with ICD-10 codes causing rejection for MDS 3.0 submissions. CMS has posted a memo which discusses:

  • The error code for these rejections
  • That if your software produces an MDS which rejects due to ICD-10 codes in I8000 that you should contact your software vendor
  • Links to jRAVEN and various QIES pages

Note- you must use Submission Specs V1.15.0 for your submissions.

If you have any questions or need additional assistance, contact Cil Bullard, the RAI/OASIS Coordinator at the Virginia Department of Health at 804.367.2141 or priscilla.bullard@vdh.virginia.gov