October 21, 2015

CHS helps clients and providers transition to new ICD-10 codes

Along with the usual changes in the weather, this October also brings changes in the medical billing world related to the International Classification of Diseases (ICD). Effective October 1, 2015, all medical providers covered by the Health Insurance Portability and Accountability Act (HIPAA) were required to start billing with ICD-10 codes. The new coding replaces the long-standing ICD-9 codes that were more generalized. The new ICD-10 system offers a wider variety of more concise descriptions of the injury or disease diagnosis. They assist providers in conveying information important for treatment and case management considerations. Although, the Ohio Bureau of Workers’ Compensation (BWC) is not held to the specific HIPAA laws, it is understood that requiring providers to maintain two separate billing processes would not be effective. Therefore, BWC also started their transition to the ICD-10 codes to coordinate with the HIPAA requirements.

So how does this affect employers? Newer claims with a date of injury October 1, 2015 and after will include ICD-10 codes only, and subsequent treatment requests and medical bills will follow suit. Claims incurred prior to October 1, and still active, will have both ICD-9 and corresponding ICD-10 codes noted on the claim. This should not be mistaken for additional conditions added to the claim, but simply a dual coding of the existing allowed conditions. CompManagement Health Systems (CHS) is prepared to address medical bills submitted by treating providers utilizing either ICD-9 or ICD-10 codes as appropriate.

BWC and CHS have been working on the ICD-10 implementation for the past two years to ensure that these changes appear seamless for our employers and their injured workers. However, as with any new implementation of this magnitude, there is the chance that we may encounter challenges related to the proper submission of treatment requests and medical bills. Problems related to the ICD-10 codes should be rare, and we have built system triggers to identify related issues so we can work directly with the treating physicians to resolve them quickly. If you or your employees experience any inconvenience that may be related to the ICD-10 transition, please do not hesitate to contact your CHS Account Executive directly or our customer service team.

For questions, please contact CHS at ClientServices@chsmco.com or call 888-247-7799 x 65606.

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