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OhioBWC - Provider:  (ICD-10) - Details

ICD-10 implementation - Latest news

Oct. 1, 2015: New ICD-10 implementation date nationwide

BWC continues to move forward in meeting the new International Classification of Diseases, tenth revision (ICD-10) code set implementation date of Oct. 1, 2015. The U.S. Department of Health and Human Services (HHS) released a final rule for that date after Congress passed legislation delaying the planned Oct. 1, 2014, transition from ICD-9 to ICD-10.

HHS reports this deadline allows providers, insurance companies and others in the health-care industry time to ramp up their operations to ensure their systems and business processes are ready to go on Oct. 1, 2015.

During this time, BWC is executing our defined project plan and strategy. This helps us successfully prepare our infrastructure and staff members for the health-care system's ICD-10 implementation. Our code-conversion efforts are for the benefit of Ohio's injured workers and employers. For additional updates, you can subscribe to Provider eNews.


BWC is updating expired ICD-9 diagnosis codes: June 10

In keeping with industry standards, we're replacing expired ICD-9 codes in our claims. Beginning June 10 we'll update all expired codes to the equivalent current codes on this website. So, before you provide services or submit bills, Use the Diagonosis info service offering to determine the current conditions/codes addressed on a claim.

Historically, in an effort to avoid billing delays, we accommodated providers using expired codes. However, as we prepare for ICD-10, we are addressing all non-standard bill-processing protocols. Because an expired code is one the health-care industry no longer uses, they cannot be applied for billing or reporting.

To ensure we're approving treatment and paying medical bills accurately, we're updating our claims to recognize only current ICD-9 codes. Our policy is to update claims using the most current and correct code(s) while retaining the narrative allowed by the original order.

Last day for processing bills with expired codes is July 31
As of July 31 we'll no longer process bills with expired diagnosis codes. If you have questions, contact the injured worker's managed care organization. For additional assistance, contact BWC's provider relations department at 614-644-6292.


ICD-10 implementation date postponed; continuing coding efforts

BWC continues to move forward with ICD-10, despite the recent legislation passed by the U.S. Congress. The legislation prohibits the adoption of the new ICD-10 code set prior to Oct. 1, 2015. This is a change from the Oct. 1, 2014, implementation date.

The bill's language leaves open the possibility that the U.S. Department of Health and Human Services (HHS) could allow the early adoption of ICD-10s while still permitting health-care entities to use ICD-9 codes. At this time, we're awaiting guidance from HHS for a new implementation date and protocols.

What the delay means for BWC
It means we continue to move forward to execute our defined project plan and strategy. This helps us successfully prepare our infrastructure and staff members for the health-care system's ICD-10 implementation. The project team is meeting to discuss and define appropriate adjustments to our plan. The delay gives us additional time for training and validation of our new coding system for the benefit of Ohio's injured workers and employers. For additional updates, you can subscribe to Provider eNews.


May 14: Condition descriptions, not diagnosis ICD codes on employer/injured worker correspondence

BWC bases claim allowances on condition descriptions provided by physicians. We then verify a numeric International Classification of Diseases (ICD) code that corresponds to the condition description. BWC systems store the code for medical bill reimbursement, claim reserving and accident/injury trending and analysis. Historically, BWC correspondence and orders included the narrative condition description and the numeric ICD code.

In preparation for the upcoming transition to ICD-10, we are changing how we provide diagnoses on BWC-generated correspondence. Beginning May 14, we will only include the narrative condition descriptions in correspondence and orders for injured workers and employers.

Codes for billing, reimbursement
However, we will continue to include narrative condition descriptions and numeric ICD codes in physician and medical provider correspondence. Providers need this information for billing and reimbursement purposes.


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