ICD-10:Preparation is Key

Start Testing Today.

The International Classification of Diseases (ICD) and its related codes provide valuable information and tracking of health conditions and health trends. ICD codes are used by insurance companies to categorize conditions and determine appropriate reimbursement.

The upcoming transition to ICD-10 is due to the need for greater detail of medical conditions being treated. With the transition from ICD-9 to ICD-10, comes a new set of codes with greater detail.

  Are you ready to test? If you are a credentialed provider who is ready  to test, please email your contact information  to ICD10@nebraskablue.com.

  BCBSNE ICD-10 Testing Deadlines
  • Test files for end-to-end testing will be accepted until Sept. 15, 2015.
  • Test files for acknowledgement testing will be accepted until Sept. 30, 2015.

BCBSNE is currently testing with the following clearinghouses (updated Sept. 1, 2015):

  • Ability Network (Medical Claim Corp MD Online)
  • Allscripts
  • Capario
  • CPSI-Trubridge
  • Emdeon
  • GE Healthcare
  • Global Health Net (Greenway)
  • Imspro–Practice Insights
  • Infinedi
  • MedAssets
  • Navicure
  • OptumInsight
  • Professional Business Services
  • RelayHealth (Note: Relay Health no longer accepts test files, as of July 31)
  • Recondo Technology
  • TKSoftware
  • Transmedic
  • Trizetto Provider Solutions–ClaimLogic
  • Zirmed

For dates of service on and after the official effective date, all claims submitted to Blue Cross and Blue Shield of Nebraska (BCBSNE) must be coded in ICD-10.

According to the American Health Informational Management Association (AHIMA), ICD-10 offers the following benefits:

  • Better data to help improve performance
  • Create efficiencies and contain costs
  • Increased specificity offers payers and providers the potential for greater cost savings

Coding for ICD-10-CM: Continue to Report CPT/HCPCS Modifiers for Laterality

On October 1, 2015, ICD-10-CM will replace the ICD-9-CM code set currently used by providers for reporting diagnosis codes. Implementation of ICD-10-CM will not change the reporting of Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, including CPT/HCPCS modifiers for physician services. While ICD-10-CM codes have expanded detail, including specification of laterality for some conditions, providers will continue to follow CPT and CMS guidance in reporting CPT/HCPCS modifiers for laterality.



The percentage of the bill you pay after your deductible has been met.


A fixed amount you pay when you get a covered health service.

Tiered benefit plan

A health care plan featuring multiple levels of benefits based on the network status of a particular provider. 


The annual amount you pay for covered health services before your insurance begins to pay.

emergency care services

Any covered services received in a hospital emergency room setting.


Includes behavioral health treatment, counseling, and psychotherapy

in-network provider

A provider contracted by your insurance company to accept an agreed upon payment for covered services. 

OUT-OF-network provider

A term for providers that aren’t contracting with your insurance company. (Your out-of-pocket costs will tend to be more expensive if you go to an out-of-network provider.)


Your expenses for medical care that aren’t reimbursed by insurance, including deductibles, coinsurance and co-payments.


If you can afford health insurance, but choose not to buy it, you must have a health coverage exemption or pay a tax penalty on your federal income tax return.


The amount you pay to your health insurance company each month. 

Preventive services

Health care services that focus on the prevention of disease and health maintenance.


Services and devices to help you recover if you are injured or have surgery. This includes physical, occupational and speech therapy.

special enrollment period

The time after the Open Enrollment Period when you can still purchase health insurance only if you have a qualifying life event (losing other health coverage, having a baby, getting married, moving).


A physician who has a majority of his or her practice in fields other than internal or general medicine, obstetrics/gynecology, pediatrics or family practice.