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ICD-9 to ICD-10 Transition Effective October 1, 2015

Posted: September 25, 2015

On October 1, 2015, BWC and CareWorks will begin implementing ICD-10, the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD) for Ohio workplace injury diagnosis codes.

This is an update from the current ICD-9 version. ICD-10 is not required for workers’ compensation claims, yet BWC has decided to implement these new codes to ensure continuity for medical providers across all payers.

Why is BWC making this change?

  • ICD-10 codes have a higher level of specificity compared to ICD-9 codes.
  • While ICD-9 had 13,000 codes to define a diagnosis, ICD-10 contains nearly 72,000 codes.
  • ICD-10 also has an increased code length to account for additional descriptive information, such as side of the body and specific site.
  • These new codes should allow for more accurate and efficient processing of claims and corresponding medical bills.

All claims with a date of injury on or after October 1, 2015, will only have ICD-10 codes for claim allowances. Active claims with a date of injury before September 30, 2015, and currently allowed with ICD-9 codes will have corresponding ICD-10s identified by BWC. There is no need to be concerned about new allowances as the ICD-10 codes are simply a “translation” of the existing ICD-9 codes.

To ensure a smooth conversion, BWC and CareWorks will allow a 90-day billing transition period through December 31, 2015, when providers can bill with either ICD-9 or ICD-10. As of January 1, 2016, all medical bills will be required to be submitted with proper ICD-10 codes.

CareWorks has already updated all of our systems and reports to show ICD codes. In the next few weeks, CareWorks clients will begin to see ICD-10 codes on reports, letters, treatment authorizations and the CareWorks Claims Portal. In some instances, we will show information with the ICD-9 and ICD-10 codes. In others, we will just show the ICD-10 code.

We are excited about this transition as we believe it will ensure faster processing of claims and smoother transactions within those claims. CareWorks is ready for this update and eager to provide the additional information to our clients. If you have any questions about this transition, or any other workers’ compensation matter, please contact your individually assigned CareWorks Account Executive. Or, call CareWorks Customer Service at 1-888-627-7586.

To download the Return to Work form, please click here.

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