What’s Up Wednesday


A monthly teleconference regarding the transition to ICD-10, hosted by Pennsylvania’s Blue Plans.
Learn more

ICD-10

The U.S. Department of Health and Human Services (HHS) has adopted a rule to replace the currently used International Classification of Diseases, 9th Revision (ICD-9) with the next-generation ICD-10 code sets by October 1, 2014.

Compliance Date

  • Outpatient claims. All outpatient claims with a dates of service on or after October 1, 2014, must be submitted with ICD-10 codes.
  • Inpatient claims. All inpatient claims with discharge dates on or after October 1, 2014, must be submitted with ICD-10 codes.

Claims that are submitted with non-compliant ICD-9 codes after this date will be rejected.

How to Prepare

All providers should be in compliance with HIPAA 5010 transaction and code set requirements as a prerequisite for the conversion to ICD-10. Physician practices and facilities should create an ICD-10 implementation plan that includes an awareness campaign and an education strategy. In addition, Independence Blue Cross urges you to complete an impact assessment of the ICD-10 transition.

In coordination with the other Pennsylvania Blue Plans, we host a monthly teleconference for health care professionals — called What’s Up Wednesday — regarding the transition to ICD-10. What’s Up Wednesday features special guests and ICD-10 experts who lead discussions to help you get ready for the October 1, 2014, compliance date. All providers, clearinghouses, information trading partners, and information networks are encouraged to participate. Visit the What’s Up Wednesday web page for more information, materials for the upcoming call, and an archive of materials from previous calls.

What Will Change

  • Diagnosis codes (ICD-10-CM) and procedure codes (ICD-10-PCS) will have more digits than ICD-9 codes; CPT® and HCPCS codes will not be affected.
  • The number of codes will increase significantly from roughly 14,000 codes to 170,000 codes.
  • The new ICD-10 codes:
    • use updated and more precise medical terminology;
    • enable laterality;
    • allow for the ability to add new codes;
    • include greater specificity (including a greater number of digits);
    • provide more detailed clinical information about conditions, diseases, and injuries.

The implementation of ICD-10 will result in more accurate coding, which will improve the ability to measure health care services, enhance the ability to monitor public health, improve data reporting, and reduce the need for supporting documentation when submitting claims.

Please visit this site frequently for updated information on ICD-10.

Resources

Frequently Asked Questions

Please refer to the following document for additional information about the transition to ICD-10.

Putting ICD-10 into Practice: Coding exercises and scenarios

Throughout 2013, our Partners in Health UpdateSM newsletter featured a series of articles titled Putting ICD-10 into Practice: Coding exercises and scenarios in preparation for the transition to ICD-10. Each month we published coding exercises and scenarios to help you put into practice the new guidelines and conventions you learned about in the ICD-10 Spotlight: Know the codes series. The booklet below includes all of these coding exercises and scenarios for your reference.

ICD-10 Spotlight: Know the Codes Booklet

Throughout 2012, our Partners in Health Update newsletter ran a series of articles titled ICD-10 Spotlight: Know the codes, which featured various examples of how ICD-9 codes translate to ICD-10 codes. These articles explored various coding conventions, general guidelines, and chapter-specific guidelines in ICD-10. We’ve compiled all the articles into the below booklet for your reference.


CPT copyright 2012 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.