State Health Care Payers Moving to ICD-10
The West Virginia Department of Health and Human Resources (DHHR), Public Employees Insurance Agency (PEIA) and Children’s Health Insurance Program (CHIP) remind all healthcare providers that new coding procedures will be required on October 1, 2015. The Health Insurance Portability and Accountability Act (HIPAA) requires the transition from ICD-9 to ICD-10 by all HIPAA-covered entities, including healthcare providers, payers, clearinghouses, billing services and others.
These agencies and their managed care organizations have been working diligently with vendors, providers and others to ensure their claims systems are ready to accept ICD-10 coding.
The DHHR Bureau of Medical Services is required to implement ICD-10 on October 1, 2015 in order to continue receiving its matching federal funds from the Centers for Medicare and Medicaid Services (CMS).
Medical providers are urged to remember to use ICD-10 codes for all services rendered on or after October 1, 2015, to ensure proper processing. Claims with dates of service after October 1, 2015, submitted with ICD-9 codes cannot be accepted, and those services will not be reimbursed until they are properly coded by the provider. Services rendered prior to October 1, 2015, must be billed with ICD-9 codes, regardless of the date of submission.
Medical providers are strongly encouraged to engage in or continue testing with each of their contracted insurance providers to help with the transition process. A request to delay the implementation of ICD-10 was made to CMS and was denied.
Medicaid providers may find more information at http://www.dhhr.wv.gov/bms/Provider/ICD10/ or at www.wvmmis.com.
More information regarding ICD-10 is available at:
For more information, contact DHHRCommunications@wv.gov or (304) 558-7899.