To ensure a smooth transition to ICD-10, Wellmark strongly recommends all providers test claims submissions through our electronic testing environment. For dates of service of October 1, 2015 and after, claims using ICD-9 codes will be rejected, so providers should begin testing now. Click below to get started.
ICD-10 testing with Wellmark is more than simply confirming that you can create electronic claims in the correct format. Rather, it will allow you to exchange and review ICD-10 data on test claims, giving you a clearer understanding regarding whether your claims will process through Wellmark’s business rules and edits as expected after the introduction of the new codes. NOTE: Wellmark does not support the testing of paper claims or those submitted through Wellmark’s online Create & Submit a Claim tool.
Benefits of ICD-10
International Classification of Disease (ICD) is a standard set of diagnosis and procedure codes used to:
ICD-10 offers additional specificity to the current ICD-9 claims reporting process. The increased granularity of choices will help providers define which services were rendered and why.
The new ICD-10 codes will more accurately reflect technology and medical treatment, improving your ability to:
ICD-10 will provide more detail to understand each patient's particular needs, illustrate patient trends, and set health care goals. It will also help to advance research, measure quality outcomes, and demonstrate value of care in a way that is not possible with ICD-9.
Key Differences with ICD-9
Even though you will use a similar process to look up ICD-10 codes as you use for ICD-9 codes, there are some differences in the code sets. The following table provides an overview of some important differences in the ICD-9 and ICD-10 code formats:
Education and Training Resources
In addition to testing information and instructions, Wellmark offers two important resources.
Additional resources are available below.