Marcia Cox
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This is a first for me but wondering if anyone can comment on this. I work with a TPA (Third Party Administrator) for a large employer group who recently told me that they have not converted their system from ICD-9 to ICD-10 (which I thought everyone was required to do in 2015). When they receive claims from medical providers the TPA compares the ICD-10 DX and chooses the closest ICD-9 DX to consider the claim for payment. This doesn't seem like it would be compliant. Any comments or suggestions on where I research this?