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FAQs concerning the ICD-10 Conversion and PIP

Question: Are services billed under the Personal Injury Protection (PIP) Medical Expense benefit coverage subject to the requirement that only ICD-10 diagnosis codes be used after October 1, 2015?

Answer: No. The conversion to ICD-10 codes is mandatory for all providers and payors subject to the Health Insurance Portability Accountability Act (HIPAA). Personal Injury Protection (PIP) Medical Expense benefit claims made under auto insurance policies are not subject to HIPAA.

However, employer health plans, Medicare and Medicaid are subject to HIPAA and they comprise the vast majority of medical services in the United States. The Department expects that providers, automobile insurers and PIP vendors have already started the process to transition to ICD-10.
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