ICD-10 Providers Information

Expanded diagnosis and surgical procedure code sets to be much more specific

Expanded field format for ICD-10 codes From 3-5 to 3-7

Compliance of HIPAA mandate to have bills paid effective 10/1/15 Bills with dates of service on or after 10/1/15 must use ICD-10

codes to be paid Bills with dates of service prior to 10/1/15 must continue to use

ICD-9 codes to have bills paid IP Bills with a discharge date on or after 10/1/15 must use ICD-

10 codes to be paid IP Bills with a discharge date prior to 10/1/15 must continue to

use ICD-9 codes to be paid Bills cannot contain both ICD-9 and ICD-10 codes on the same

bill

What changes with ICD-10?

The Office of Workers’ Compensation Programs (OWCP) will adopt the use of the International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10) on a schedule aligned with the Centers for Medicare & Medicaid Services (CMS)

  For services provided on or after October 1, 2015, OWCP will require

all providers to only use the ICD-10 code sets

For services provided prior to October 1, 2015, only ICD-9 codes will be accepted

  We will be following CMS guidance for implementing ICD-10 on

October 1, 2015.  Please visit the CMS ICD-10 website for additional information, resources and the latest news on the ICD- 10 transition, http://www.cms.gov/Medicare/Coding/ICD10/index.html?redirect=/icd10

ICD-10 AnnouncementsProvider

The National Uniform Claim Committee (NUCC) has approved a transition timeline for the version 02/12 1500 Health Insurance Claim Form (1500 Claim Form).  In June, the NUCC announced the approval of the updated 1500 Claim Form that accommodates reporting needs for ICD-10 and aligns with requirements in the Accredited Standards Committee X12 (ASC X12) Health Care Claim: Professional (837P) Version 5010 Technical Report Type

Effective March 1, 2014: Payers receive and process paper claims submitted only on the revised 1500 Claim Form (version 02/12)

1500 Claim Form Changes

Instructions on completing the new 1500 can be found at the following website under forms and links http://owcp.dol.acs-inc.com/portal/main.do

How to Submit a 1500