OhioBWC - Provider: (ICD-10) - Details | ||||
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ICD-10 implementation - Latest news |
New fact sheet provides post-implementation updates BWC was ready when the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD)-10-CM implementation began nationally on Oct. 1, 2015. Now we are several months post implementation, and we have five specific coding-efficiency issues to communicate with you. These issues relate to our coding customizations and differences. This post-implementation fact sheet has more details and a spinal/back sprain and strain table. |
BWC's grace period to accept ICD-9 codes on bills expires Dec. 31 You must submit bills for dates of service after Dec. 31, 2015, using only ICD-10 codes. As of Jan. 1, BWC's managed care organizations (MCOs) will deny bills not meeting this requirement with EOB 343 - Payment is denied as billed diagnosis code is not valid on the date of service. If this occurs, you must bill again with the appropriate ICD-10 code. Also, remember to code what you are treating and to check your electronic website account for BWC's allowed conditions. For help with BWC specific ICD-10 coding, please visit our ICDs for Ohio workers' comp information section. |
Getting down to specifics for claim allowance and billing As of Nov. 24, this website features a new section for providers that identifies the differences between coding for claims and bills. It also features two new lists to assist providers with validation of ICD-10 codes. The first list highlights codes that are not usually appropriate for claim allowances. The second list highlights the most frequently allowed conditions with ICD-9 codes and their associated ICD-10 codes. Access the new section ICDs for Ohio workers' comp from the left-side menu under Services. |
BWC, MCOs now taking ICD-10 codes; specific codes are important We did it! BWC and our managed care organizations (MCOs) transitioned to ICD-10 on Oct. 1. Thank you for your cooperation during this transition and for using electronic accounts for your claim needs. We continue to work closely with the MCOs to provide the best service possible for you and Ohio's injured workers. Be specific, complete when coding diagnoses BWC and MCOs use diagnosis groupings in bill processing S and T categories Resources
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BWC, MCOs now taking ICD-10 codes On Oct. 1, BWC, along with the rest of the nation, implemented the International Classification of Diseases (ICD-10). This means Health Insurance Portability and Accountability Act (HIPAA)-compliant providers do not need to make special accommodations for their patients with a workers' compensation claim resulting in uninterrupted services for your employees.
More specific for injuries
Bottom line for employers For more information, review our ICD-10 Implementation Guiding Principles Fact Sheet or email BWC's provider relations department. |
ICD-10 readiness - For the MCOs On Sept. 8, 2015, staff from all 15 certified managed care organizations (MCOs) received BWC training on ICD-10 implementation. This meeting focused on the agency goal for a seamless transition on Oct 1. Topics included the handling of ICD-10 codes for:
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Q & A: Common questions about ICD-10 and BWC 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) 1A: 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.
Injury descriptions
Resources available for general ICD-10 education, information
Road to 10 |
ICD-10 coding is in full swing at BWC! We have joined the ICD-10 coding effort, even though we're not mandated to do so.
BWC's commitment
Provider-treatment plans If you have questions, please email BWC's provider relations department. |
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. |