ICD-10 Rejections for Age and Gender validations
ICD10 IMPLEMENTATION:
In order to be fully compliant with the ICD-10 implementation plan as outlined by the National ICD-10 Task Team,
stakeholders must have successfully implemented Phase 3 and Phase 4.1 by the 1
Phase 3 (already implemented):
Switchboard: 011 770 6000
Call Centre: 0860 932 273
Website: www.medikredit.co.za
2nd Floor President Place,
Cnr Jan Smuts Avenue & Bolton Road,
Rosebank, Johannesburg, 2196
Directors: Dr S C P Belamant; A Keschner; H G Kotzé
ectors: Dr S C P Belamant; W J du Plessis; H G Kotzé
Switchboard: 011 770 6000
Call Centre: 0860 932 273
st
of July 2014.
All health care providers are required to submit claims with complete codes (3rd, 4th or 5th character codes,
as appropriate). The validation process for primary and secondary codes continues during this phase.
Phase 4.1 to be implemented on 1 July 2014:
Rejections for Age and Gender validations as contained in the Master Industry Table (MIT) will be
implemented on the 1st of July 2014.
Please note that the Task Team has agreed to defer the validation and rejection of Paediatrician claims
(practice type 32 and 33) for the ICD-10 age and gender edits from 01 July 2014. MediKredit therefore will
not apply these changes to discipline types 32 & 33 effective 1st of July 2014.
RMR Codes
2103 – Diagnosis is invalid for the patient’s gender
2102 – Diagnosis is invalid for the patient’s age
4336 – Diagnosis is for Age younger than 19
4335 – Diagnosis is for Age 19 years or Older
This will only affect claims from service date of 01/07/2014. Claims before the 1st of July will not be affected.