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ICD-10 Diagnosis and Procedure Codes

Latest Update 5/20/14

 

On April 1, 2014, the Protecting Access to Medicare Act of 2014 was signed into law. The bill includes a provision that effectively delays the implementation of ICD-10 diagnosis and inpatient procedure codes for at least one year.  

 

We are committed to meeting the requirements of all mandates, including the implementation of the ICD-10 code set.  

General Information on ICD-10

International Classification of Disease (ICD) is a standard set of diagnosis and procedure codes used to:

  • Identify symptoms, conditions, problems, complaints or other reasons for medical services or procedures being provided.
  • Translate written information in a patient's chart into a form that can be submitted electronically for reimbursement.
  • Identify provided procedures and services.
  • Establish current world mortality code for death records.

The federal government mandated implementation of the new ICD-10 code set for services provided on and after October 1, 2015. The new code set provides more detail in diagnosis and hospital procedure codes used by doctors, hospitals, and insurers.

 

CMS has announced a plan to implement the new CMS-1500 form — the form used for billing professional services — (version 02/12) beginning Jan. 6, 2014. 

 

The transition to ICD-10 is required for everyone covered by the Health Insurance Portability Accountability Act (HIPAA).  Please note: the change to ICD-10 does not affect CPT coding for outpatient procedures and physician services.

Benefits of ICD-10

The new ICD-10 system will more accurately reflect technology and medical treatment, improving your ability to:

  • Measure health care outcomes.
  • Enhance clinical decision-making.
  • Track public health issues.
  • Conduct medical research.
  • Identify fraud and abuse.
  • Appropriately pay for services provided.

Wellmark’s Plans for ICD-10 Regulatory Conversion

In 2011, Wellmark assessed its systems, business processes, policies, and communication needs associated with the impacts of the ICD-10 conversion.  Throughout 2012-2014, Wellmark will update all systems and processes to use ICD-10 codes to meet the compliance timeframes.

ICD-10 Timeline

ICD-10 Testing

Information regarding ICD-10 testing with Wellmark will be provided closer to 2015; please check our ICD-10 Testing page for updates and details.

ICD-10 Frequently Asked Questions

Wellmark will add information to this FAQ regularly, so check back often.

ICD-10 Education and Training Resources



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