Latest Update 05/17/2013
On October 1, 2014, the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets. These code sets, known as the International Classification of Diseases, 10th Edition diagnosis and procedure codes, or ICD-10, will include codes for new diagnoses and surgical procedures that improve the quality of information available for quality improvement and payment purposes.
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.
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, 2014. The new code set provides more detail in diagnosis and hospital procedure codes used by doctors, hospitals, and insurers.
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. In 2012-2014, Wellmark will update all systems and processes to use ICD-10 codes to meet the compliance timeframes.
Wellmark’s plan is being integrated with key business partners, including vendors and clearinghouses. Periodic updates will be shared with the provider community and other stakeholders. Targeted provider testing is projected to begin in the early second quarter of 2014.
ICD-10 Frequently Asked Questions
Here are some frequently asked questions regarding Wellmark’s plans and progress to ICD-10. Wellmark will add information to this Q&A regularly, so check here often.
ICD-10 Education and Training
Any business process or technology that stores, processes, or utilizes medical/diagnosis/procedure codes is affected on some level. Learn more about ICD-10 by viewing additional online resources at http://www.cms.gov/Medicare/Coding/ICD10/index.html?redirect=/icd10 .
Additional ICD-10 Resources
Look for additional resources on the following sites: