On October 1, 2015, all entities covered by the HIPAA privacy law, including health care providers and their business associates that regularly receive health information, are required to begin using a new set of diagnostic codes known as ICD-10. ICD stands for “International Classification of Diseases”. Workers’ Compensation agencies such as the Ohio Bureau of Workers’ Compensation (BWC), insurers and employers (who are not otherwise covered by HIPAA) are exempt from the requirement to convert to the new coding system. However, the BWC announced that it will convert to ICD-10 on October 1. The reason is simply one of practicality: health care providers who accept Medicare and Medicaid and other types of insurances are required by law to submit their fee bills using the new coding, and it would be impractical to expect workers’ compensation healthcare providers to use and maintain both ICD-9 and ICD-10 coding systems.
28 Sep 2015
Since it is the legal, written description of the injury and not the coding that governs any disputes over workers’ compensation conditions, employers need to pay close attention to the written description of a particular injury to ensure that the written description matches the treatment notes. For most employers, this will be handled primarily by a third party administrator for their workers’ compensation program. However, employers should always look at any correspondence from the BWC that either allows a claim or adds new conditions to the claim to be sure that the written description of the injury is accurate.If you have any questions regarding the new coding implementation or other questions about Workers’ Compensation please call at 937-223-1130 and speak to one of our Workers’ Compensation attorneys. For more information, visit our website at www.pselaw.com.