• ICD-10

    Learn and Share Ideas at Monthly ICD-10 Conference Calls 

    The ICD-10 conversion deadline of Oct. 1, 2014 is fast approaching. To help providers prepare and share information, the Washington State Hospital Association, Washington State Medical Association, and OneHealthPort are sponsoring a series of monthly ICD-10 conference calls featuring several topics, including: engaging physicians, dual coding, trading partner preparedness ideas, and more. There will be one topic per call with 5-6 provider organizations presenting what they’re doing to get ready. The calls are on the first Tuesday of every month from noon to 1 p.m. Submit your contact information to be added to the distribution list.

    ICD-10 Reminder: We are not able to accept ICD-10 codes on claims until the implementation date of Oct. 1, 2014. Claims sent using ICD-10 codes prior to Oct. 1, 2014, will be returned. Thank you for your cooperation.

    What is ICD-10?

    The International Classification of Diseases (ICD-10) is a system that facilitates a statistical classification of disease published by the World Health Organizationand is one of several means for reporting procedures performed in acute care facilities.

    ICD-10 code sets have been widely-used internationally for more than a decade to report patient health conditions. It also is used for mortality reporting in the United States. The U.S currently uses ICD-9 coding both to report patient health conditions and facilitate claims processing and provider reimbursement.

    The U.S. Department of Health and Human Services (HHS) has mandated use of ICD-10 codes in the U.S. on all HIPAA transactions by Oct. 1, 2014 for both reporting and payment of claims. HHS recently announced a proposed rule that may extend the ICD-10 compliance date.

    How is Premera preparing for ICD-10?

    For Premera, ICD-10 implementation will impact processes across the company; however, we are prepared. Our implementation planning is well underway, and we will meet the federal compliance date.

    • Our implementation approach allows us the operational capability to respond to any changes to the HHS requirements for the mandate, including an extension of the compliance date.
    • We understand this is a significant transition for providers. Our plan will include testing with key providers and clearinghouses in advance, and we will monitor claims closely post-implementation to ensure any impacts are identified and resolved early in the process.
    • Premera will work collaboratively with healthcare providers, associations and other external entities (where appropriate) to assist in their efforts of compliance regarding the ICD-10 mandate.

    How can providers prepare for ICD-10?

    Provider awareness and preparedness are crucial in making a smooth transition to ICD-10. Provider offices can minimize impacts if they have anticipated, learned, and prepared for the changes, as well as for the potential setbacks.

    • Premera encourages providers to develop an implementation strategy that includes an assessment of the impact on their organization, a detailed timeline and budget
    • We will continue to inform providers about steps they can take to prepare and direct them to ICD-10 resources
    • We are working with individual facilities to ensure that their contracts are compliant with ICD-10 requirements

    Key steps for provider readiness

    • Identify training needs
    • Familiarity with code sets for all physicians, nurses, employees
    • Refresh of medical terminology (and biomedical sciences) for billers, office staff and coders
    • ICD-10 certification training required for coders – estimated six to nine months before compliance date
    • Reach out to trading partners about ICD-10 to determine their readiness (clearinghouses, billing services, vendors, etc.)

    Resources