ICD-10:Preparation is Key

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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 is currently testing with the following clearinghouses:

  • Capario
  • CPSI-Trubridge
  • Emdeon
  • GE Healthcare
  • Imspro–Practice Insights
  • MedAssets
  • Navicure
  • OptumInsight
  • RelayHealth
  • TKSoftware
  • Trizetto Provider Solutions–ClaimLogic
  • Zirmed

With enactment of the Protecting Access to Medicare Act of 2014, CMS is examining the implications of the ICD-10 provision and will provide guidance to providers and stakeholders soon.

This provision in the statute reads as follows: “The Secretary of Health and Human Services may not, prior to October 1, 2015, adopt ICD-10 code sets as the standard for codes sets under section 1173 (c) of the Social Security Act (42 U.S.C. 1320d-2 (c)) and section 162.1002 of title 45, Code of Federal Regulations.”

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