MedicaidBilling CodesHigh impact
Effective Dates and Transition Information for ForwardHealth's Implementation of ICD-10 Code Sets
Wisconsin Medicaid (ForwardHealth)·WI·Coding
Effective date
Oct 1, 2015
We identified it
Jun 20, 2026
Summary
ForwardHealth (Wisconsin Medicaid) is implementing ICD-10 code sets effective October 1, 2015, replacing ICD-9 codes. All claims and prior authorizations for dates of service on/after October 1, 2015 must use ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes with maximum specificity required, while ICD-9 codes remain required for dates before October 1, 2015.
Action Required
By October 1, 2015: Billing team must update all systems to use ICD-10-CM diagnosis codes (3-7 characters) and ICD-10-PCS procedure codes (7 characters) for all Wisconsin Medicaid claims with dates of service on/after October 1, 2015. Ensure maximum code specificity is used or claims will be denied. Continue using ICD-9 codes for dates of service before October 1, 2015. Update prior authorization requests to use appropriate code set based on requested start date. Train staff on new code formats and specificity requirements.