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International Classification of Diseases (ICD) MO HealthNet Claim Filing Guidelines

Missouri Medicaid (MO HealthNet)·MO·Provider Notice
Effective date
Oct 1, 2015
We identified it
Jun 20, 2026
Days to comply

Summary

MO HealthNet providers must select ICD-9 or ICD-10 codes based on service dates, not filing dates. For services on/before September 30, 2015, use ICD-9; for services on/after October 1, 2015, use ICD-10. Special rules apply for DME (use start date) and inpatient claims (use discharge date).

Action Required

Action needed
Immediately: Billing team must update MO HealthNet claim filing procedures to select ICD codes based on service dates. For services on/before 9/30/2015 use ICD-9, for services on/after 10/1/2015 use ICD-10. For DME claims spanning the transition, use ICD-9 if start date is in September. For inpatient claims spanning the transition, use ICD-10 if discharge date is in October. Update billing system rules and staff training accordingly.