The International Classification of Diseases (ICD) is a system used to code and classify morbidity data from physician offices and hospitals.
The federal and provincial governments rely on this data to calculate and report morbidity statistics for their populations. Accordingly, provincial governments have mandated that physicians provide an ICD code as a component of each billing claim.
As with any required claim information, if ICD information is incorrect (e.g., an ICD code that doesn’t coincide with the service rendered) or missing, the payment may be delayed as the claim will be returned to the physician for correction or additional information.
Manitoba Health now requires 4 digit ICD codes. If a claim has an ICD code without 4 digits it will be returned with an appropriate Explanation of Benefit code e.g., H0 This service was refused as the ICD9 submitted does not coincide with the benefit catalogue item submitted, or L1 This ICD9 indicates an unspecified disorder or condition. Please change the ICD9 to a more specific code or provide supportive information to assist us in assessing your claim.
Unsure about which ICD code applies, contact Manitoba Health at (204) 786-7361.
Updated: December 2016