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Kansas Medicaid Adoption of the Medicare List of Unacceptable Principal Diagnosis Codes

Date: 07/12/2017

Effective with dates of service on and after June 1, 2017, the Medicare list of unacceptable principal (primary) diagnosis codes was adopted by Kansas Medicaid. This list was effective by Medicare on October 22, 2016. The complete Medicare list of unacceptable principal (primary) diagnosis codes can be accessed on the Details for title: FY 2017 Final Rule and Correction Notice Data Files page of the CMS website. Once the page opens, scroll down to the Downloads box and click the Definition of Medicare Code Edits v34 link. Next, click open the ICD-10 MCE folder, then the Definitions of Medicare Code Edits v34_I10.pdf. The groups of codes referenced from the Medicare document are:

• External causes of morbidity

• Manifestation codes*

• Unacceptable primary diagnosis codes*

* Updated June 1, 2017

Note: As a reminder, all ICD-10 Coding Guidelines must be followed.