The Division of Workers’ Compensation has adopted changes to a medical billing regulation and to the DWC Medical Billing and Payment Guide to postpone the ICD-10 compliance date for one year, to October 1, 2015.
ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems, a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.The code set allows more than 14,400 different codes and permits the tracking of many new diagnoses. The codes can be expanded to over 16,000 codes by using optional sub-classifications. The detail reported by ICD can be further increased, with a simplified multi-axial approach, by using codes meant to be reported in a separate data field. The deadline for the United States to begin using Clinical Modification ICD-10-CM for diagnosis coding and Procedure Coding System ICD-10-PCS for inpatient hospital procedure coding is set at October 1, 2015, The implementation of ICD-10 has been subject to previous delays at the federal regulatory level.
The International Classification of Diseases – 10th Revision, Clinical Modification (ICD-10-CM) and the International Classification of Diseases – 10th Revision, Procedure Coding System (ICD-10-PCS) were adopted for workers’ compensation in February 2014, with an implementation date of October 1, 2014 to coincide with the Health Insurance Portability and Accountability Act (HIPAA) then anticipated implementation date.
Subsequently, the U.S. Department of Health and Human Services issued a final rule postponing use of the ICD-10 until October 1, 2015, for HIPAA-covered entities. For workers’ compensation, the Administrative Director has amended the Medical Billing and Payment Guide to align the workers’ compensation ICD-10 transition date with the October 1, 2015 ICD-10 transition date applicable to HIPAA-covered entities and the broader health care sector. All workers’ compensation participants are encouraged to move forward expeditiously to prepare for the transition.
The revised regulation and the Medical Billing and Payment Guide can be found on the Division’s approved regulations web page.