ICD-10 code Updates, Effective October 1, 2016

October 4, 2016

ICD-10 Testing Through EDI

CMS issued an updated list of additional ICD-10 codes, effective October 1, 2016. This update provides instructions to submitters on how to test the new ICD-10 claims through EDI.

  • The submitter must ensure that the ISA15 data element of the Interchange Control Header Segment of the submitted file is set to 'T' (for test files).
  • The submitter must ensure that their own processes correctly detect the presence of a 'T' in the ISA15 data element of the Interchange Control Header Segment of the resulting outbound X12 files (for example, 277CA and 835), so that they do not inadvertently pull test outbound files into their production processes.

All claim types can be tested in the ICD-10 Testing Environment, including Professional and Institutional Claims.

Production Site for Testing Learn more about third-party links

For providers wishing to test claim submission and processing using ICD-10 codes that are effective 10/01/2016, the "Test" Effective Start Dates will be July 1, 2016. Providers can bill test claims with the new ICD-10 codes with dates of service on or after 07/01/2016.

Further information about ICD-10 Testing can be found by contacting the New Mexico HIPAA Helpdesk at:

This update is not intended to provide instructions for submitting a claim through EDI. Instructions can be found here, EDI Online Submission Instructions PDF Document.