Minnesota Department of Health (MDH)
October 2013
Implementation and Compliance Update #9.0
Compliance with Minnesota health care e-billing requirements:
Use ICD-10 for health care dates of service on or after 10/01/2014
Minnesota Statutes § 62J.536 Implementation and Compliance Update #9.0
Purpose of this document and intended
audience
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This document is intended primarily for
health care “group purchasers” (payers)
subject to Minnesota’s requirements for the
standard, electronic exchange of health care
claims and other administrative transactions
pursuant to Minnesota Statutes, section
62J.536, and any other interested parties.
This document applies to all group
purchasers subject to MS §62J.536,
including entities not subject to federal
HIPAA administrative simplification
regulations (property-casualty, workers’
compensation, and auto payers).
The primary purpose of this document is to
affirm that ICD-10 coding must be used for
health care dates of services on or after
October 1, 2014.
Important Information for Compliance
The “5010” and “D.0” versions of standard,
electronic transactions must be used.
In order to be compliant with Minnesota law,
standard, electronic health care administrative
transactions must use versions 5010 and D.0 of
national transactions standards and must comply
with applicable MUCGs. Clearinghouses and
other vendors may be used as part of the
transaction exchange process to ensure that
noncompliant transactions are converted to
compliant versions as needed.
In addition, ICD-10 coding must be used and
accepted for medical dates of service on or
after October 1, 2014.
The requirement to use ICD-10 applies to all
group purchasers, including entities not subject
to HIPAA administrative simplification
regulations.
Relevant state law
For additional information
The Minnesota Department of Health (MDH)
administers Minnesota Statutes, section 62J.536
(MS §62J.536) and related rules that require the
standard, electronic exchange of certain health
care business (administrative) transactions.
Please see resources such as the federal Centers
for Medicare and Medicaid (CMS) website, at
http://www.cms.gov/Regulations-andGuidance/HIPAA-AdministrativeSimplification/Versions5010andD0/background.
html and
http://www.cms.gov/Medicare/Coding/ICD10/in
dex.html?redirect=/icd10.
The Minnesota Department of Labor and
Industry (DLI) administers Minnesota Statutes,
section 176.135, which also requires “e-billing”
of workers’ compensation medical claims
consistent with MS §62J.536.
Required e-billing specifications are found in
rules known as “Minnesota Uniform Companion
Guides (MUCGs)” at:
http://www.health.state.mn.us/asa/rules.html
or
http://www.health.state.mn.us/auc/guides.htm.
Division of Health Policy
Golden Rule Building, P.O. Box 64882
St. Paul, MN 55164-0882
651-201-3550 www.health.state.mn.us
Contact us directly:
David K. Haugen, Director, Center for Health
Care Purchasing Improvement
 Email: [email protected]
 Voice: 651-201-3573
 Website: www.health.state.mn.us/asa.
This document is available for free at:
http://www.health.state.mn.us/asa/implement.html.