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.

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.

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 (updated 7.27.15):

  • 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 will accept ICD-10 test files until 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