Agent News
September 2015
As you may be aware, entities covered under the Health Insurance Portability and Accountability Act (HIPAA) will be required effective Oct. 1, 2015, to use to a new coding system called ICD-10 to report injuries and illnesses to the Centers for Medicare and Medicaid Services (CMS). To help you understand this change and communicate it easily with your customers, we’ve provided the answers to some frequently asked questions below.
What does ICD-10 stand for?
International Classification of Diseases. The 10 indicates this is the 10th revision of this system, which is utilized by the World Health Organization and had its origins in the 1700s.
What is the difference between ICD-10 and ICD-9?
ICD-10 is a more flexible, larger and detailed code set that allows for greater specificity and precision in describing a patient’s diagnosis and in classifying inpatient procedures. ICD-10 uses five to seven characters and offers about 68,000 coding options whereas ICD-9 uses three to five characters and only offers about 14,000 coding combinations. The most notable change is the ability to specify what part of the patient is injured, such as right arm or left leg.
What motivated the change?
As part of HIPAA’s passage in 1996, a new universal standard for diagnosis coding was mandated. Physicians, clinics and hospitals are all required to move to this system for all services provided on Oct. 1, 2015, and after. The deadline for implementation of ICD-10 was delayed twice, but no further delays are anticipated.
What are the benefits of moving to ICD-10?
From a workers’ compensation perspective, ICD-10 will improve the ability to analyze health care utilization, cost, outcomes, and resource use and allocation. It also offers the potential for developing enhanced analytics that could prevent and detect health care fraud and abuse. For our customers and their claims handlers and nurse case managers, ICD-10 should result in better reporting and injury tracking capabilities as well as greater accuracy for reimbursement.
How has Accident Fund prepared for ICD-10 implementation?
Accident Fund and Accident Fund Holdings have been anticipating this transition for the last few years and have updated our systems to ensure that the move to ICD-10 will be seamless to our agents and policyholders. Our claims handling experts have been thoroughly trained on this new coding system and will be able to respond effectively to any questions our customers may have.
Why is ICD-10 and our preparations for this transition important for you and your customers?
When your customers’ employees experience injuries, they expect claims to be handled effectively and efficiently. By providing a seamless transition to the ICD-10 system, Accident Fund and Accident Fund Holdings illustrate our commitment to deliver the superior workers’ compensation product your customers have come to expect. Additionally, ICD-10 will give us the capability to better manage and track claims and ensure continued positive outcomes for injured claimants.
For more details about ICD-10 compliance, visit the Centers for Medicare & Medicaid Services’ page here.
A reminder that security administrators should periodically review their list of users for Accident Fund’s website. It is the responsibility of our agencies to add, modify and delete users – and it’s extremely important that the list is maintained with accurate information. It should be noted that as long as a user has an active user ID and password, they can access your data from virtually anywhere, even if they’ve left your agency.
It is also a good idea to have a secondary security administrator designated for each agency location in case the primary administrator is out of the office and a change needs to be made. Click here for instructions on how to view and modify your users list.
