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ICD-10 Compliance Date October 1, 2015

On July 31, 2014, the Department of Health and Human Services announced the final ruling for the ICD-10 effective date as October 1, 2015. This ruling applies to all entities covered under the Health Insurance Portability and Accountability Act (HIPAA).

BlueCross has established an ICD-10 program team to remediate all core business systems, surrounding systems, reporting capabilities and trading partner interfaces to accommodate ICD-10 coding after the compliance date.  In addition, we will continue engaging professional associations across the state with whom to coordinate efforts.

ICD-10 Implementation Information – Video

ICD-10-Compliant Prior Authorization Requests

  • Prior authorization requests can now be submitted for dates of service beginning on Oct. 1, 2015.  These requests should be submitted with applicable ICD-10 codes.
  • Retrospective prior authorization requests for dates of service before Oct. 1, 2015, should be submitted with applicable ICD-9 codes.
  • Prior authorization requests that have already been approved that span the Oct. 1 compliance date will not need to be resubmitted. BlueCross’ claim matching functionality allows existing authorizations that span the compliance date to pay with claims submitted using the appropriate diagnosis version (ICD-9 or ICD-10), based on the claim dates of service to comply with the Oct. 1, 2015 implementation of ICD-10.

International Classification of Diseases, Tenth Revision (ICD-10) is published by the World Health Organization (WHO). For our purposes, it primarily serves to provide uniform language that accurately describes diagnosis and procedure information for claims processing, research, and analysis.

Preparing for ICD-10

Providers can use our testing tool to evaluate ICD-10 coding knowledge with case scenarios.

There is a separate link, depending on the type of provider, to access the ICD-10 testing tool that will be applicable to your practice or institution.

Click here for testing information.

Frequently Asked Questions

Find the latest information from the BlueCross project team by reviewing the FAQs.

Keep Up to Date on ICD-10

Please visit the Centers for Medicare and Medicaid Services (CMS) the ICD-10 website for the latest news and resources to help you prepare. CMS also provides implementation guides on their website for Small Hospitals, Large Practices, and Medium/Small Practices

Useful ICD-10 Links and Information

Training Resources

The American Association of Professional Coders (AAPC) has training information available on its website, as does the American Health Information Management Association (AHIMA).

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