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New Workers' Compensation Coding System Goes Into Effect Oct. 1: Are You Ready?


Effective October 1, 2015, the Centers of Medicare & Medicaid Services (CMS) will require the health care industry and all Medicare responsible reporting entities to begin using a new system for coding and reporting workplace injuries and illnesses. This includes workers’ compensation insurers and claims administrators.

The International Classification of Diseases, Modification, and Procedural Coding Systems (ICD-10) represents a potentially significant improvement over the outdated ICD-9 system. ICD-10 allows for greater specificity of diagnoses, including laterality (whether an injury is to a left or right limb or other body part).

For employers, the transition to ICD-10 should yield better quality measurement, better reporting and injury tracking capabilities, and greater accuracy for reimbursement. But converting all pre-October 1, 2015, claims to ICD-10 may be costly and time-consuming.

“New Workers’ Compensation Coding System Goes Into Effect Oct. 1: Are You Ready?”, developed in conjunction with leading Medicare secondary payer compliance firm Franco Signor, reviews what the transition to ICD-10 means for employers and how they can prepare.

Among other steps, employers should establish and maintain a consistent method for reporting claims, and work with their claims advisors to:

  • Test systems for ICD-10 compliance before October 1, 2015.
  • Train claims adjusters.
  • Develop or procure tools to look up ICD-10 codes and convert codes from ICD-9.
  • Ensure bill review agents can share data to eliminate discrepancies between ICD-9 and ICD-10.