In 2014, the U.S. Department of Health and Human Services (HHS) issued a rule finalizing October 1, 2015 as the compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10.
We will continue to work to help ensure that our systems, supporting business processes, policies and procedures successfully meet the implementation standards and deadlines without interruption to day-to-day business practices. We will be capable of accepting and processing ICD-10 diagnosis and inpatient procedure codes on the mandated compliance date.
Key Project Information
We have made several key decisions that will guide our implementation strategy and will be useful as you plan your transition to ICD-10.
ICD-10 Claims Processing
ICD-10 Pre-Authorizations and Claims Filing
ICD-10 FAQs for Providers
This FAQ contains educational information about ICD-10, as well as answers to questions about our ICD-10 implementation
Attention Professional Providers! Coding Practice Tool Available
To support ICD-10 readiness with professional providers
, we are offering a free scenario-based coding practice tool designed to give physicians and their coders the opportunity to test their knowledge of the ICD-10 codes set by applying it to medical scenarios.
April ICD-10 Topic: Successful ICD-10 End to End claims testing yield valuable Lessons Learned
As part of our approach to discovering, understanding and predicting the impact of ICD-10, we’ve conducted extensive End to End Testing with selected providers and clearinghouses. Here’s what we learned:
Lesson Learned #1: We are able to accept and deliver electronic claim files with ICD-10 codes through our EDI gateway. We successfully tested with 13 clearinghouses and received 91% of the claims submitted for testing.
Lesson Learned #2: We can process claim files with ICD-10 codes on all claims systems tested. We successfully tested with the five (5) local claims platforms that support our 14 Blue Markets and the two (2) national platforms, FEP and NASCO. We we able to process over 6,900 test claims submitted by providers. Claim edits performed as expected in our test environment.
Lesson Learned #3: Our systems can process preauthorizations containing ICD-10 codes. Our care management team conducted a successful testing effort with providers. Preauthorizations processed with no issues.
Lesson Learned #4: From a medical management perspective, there was virtually no impact due to ICD-10 codes. Claims were reviewed for pay/pend/deny status to see if this would change with using ICD-10 codes. No changes were found.
For more details on the End to End Testing, read our ICD-10 End to End Testing Summary
ICD-10 Implementation Resources to assist you
Suggested resources to help with your ICD-10 transition and prior Monthly ICD-10 Topics.
For ICD-10 questions and surveys, email us at ICD10-Inquiry@bcbsga.com