We're highlighting common questions and answers (Q & A) we've received about our transition to ICD-10 on Oct. 1, 2015, with the rest of the nation. To make this transition as smooth as possible,
BWC and our MCOs are implementing measures that allow us to process claims and bills using ICD-9 codes, if necessary, for 90 days past the Oct. 1 effective date.
Here are answers to three commonly asked questions.
1Q: How does ICD-10 implementation affect reporting a claim? - Coding Guidelines for the First Report of an Injury, Occupational Disease of Death (FROI)
Providers should only submit one version of codes on the FROI. For dates of injury prior to Oct. 1, 2015, use ICD-9 codes. For dates of injury on or after Oct. 1, 2015, use ICD-10 codes.
2Q: Are providers testing bill submissions for ICD-10 with MCOs and BWC?
2A: Yes. Testing is in progress right now through BWC's HPP systems support unit and the MCOs' billing contacts. We will complete a final round of testing to confirm everyone is prepared to process bills containing ICD-10 codes.
3Q: How does ICD-10 affect treatment requests in existing claims?
3A: Physician's Request for Medical Service or Recommendation for Additional Conditions for Industrial Injury or Occupational Disease (C-9)
- Section III of the C-9 requests a narrative description of requested conditions. The narrative should be as specific as possible so we can ensure we can code the ICD-9 and ICD-10 from the request appropriately.
For answers to your questions about ICD-10 and BWC, please review the ICD-10 Implementation Guiding Principles Fact Sheet. For more information, email BWC's
provider relations department.
Remember for workers' compensation, claims determinations are based on injury descriptions, not disease codes. Therefore, claims determinations should not be affected by the ICD-10 implementation.
Resources available for general ICD-10 education, information
As providers, you're essential in providing care for Ohio's injured workers. We're implementing and adopting ICD-10 to mitigate any barriers and negative impacts we could face as a payer. In addition,
our goal is to continue to provide you the best customer service possible from treatment planning to billing. In this effort, we're sharing some of the resources available from the
Centers for Medicare & Medicaid Services (CMS). These may help you with the transition from ICD-9 to ICD-10.
Road to 10
For example, CMS reminds providers that the change to ICD-10 does not affect CPT coding for outpatient procedures and physician services. You also may jump start your ICD-10 transition with
Road to 10, an online resource built with input from providers in small practices. This resource includes specialty references and helps providers
build ICD-10 action plans tailored for their practice needs.