By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    benefits of using protein powder to build muscles
    Protein Powder for Muscle Mass: Everything You Need to Know
    December 12, 2021
    changes brought on by blockchain in healthcare
    Technology In The Healthcare Industry
    March 28, 2022
    What Does Core Body Temperature Say About Health?
    August 17, 2022
    Latest News
    Clean Your Mattress Properly to Avoid Common Health Issues
    March 29, 2023
    5 Benefits Of HIPAA-Compliant Answering Services
    March 28, 2023
    3 Ways To Deal With Health Issues In Cities With High Pollution
    March 22, 2023
    What Tools Should Your Caregiver Have?
    March 22, 2023
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    Disease Registries Help Doctors Share Information
    December 16, 2011
    Low Health Literacy Video: Too Important Not To Watch!
    January 9, 2012
    Diabetic Emergencies 101
    February 8, 2012
    Latest News
    What Are Bioidentical Hormones Made With?
    March 23, 2023
    Cover Medical Costs of Child Dog Bites with Legal Specialists
    March 23, 2023
    3 Ways to Improve the U.S. Healthcare System By 2030
    March 14, 2023
    6 Steps To Ensure Speed And Efficiency Of Clinical Studies
    March 14, 2023
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Workers’ Compensation and ICD-10
Share
Sign In
Notification Show More
Latest News
improve self-esteem to fight depression
7 Ways to Enhance Your Self-Esteem to Fight Depression
Mental Health
healthy travel tips when visiting Australia
7 Essential Tips to Stay Safe and Healthy Visiting Australia
News
health risks of dirty mattress
Clean Your Mattress Properly to Avoid Common Health Issues
Health
eligble for NDIS?
Are You Eligible For NDIS? How To Apply
News
upgrade to your nursing career
4 Pertinent Ways to Upgrade Your Nursing Career
Nursing
Aa
Health Works CollectiveHealth Works Collective
Aa
Search
Have an existing account? Sign In
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Business > Finance > Workers’ Compensation and ICD-10
BusinessFinanceHealth ReformHospital AdministrationMedical RecordsPublic Health

Workers’ Compensation and ICD-10

Andy Salmen
Last updated: 2013/05/18 at 8:09 AM
Andy Salmen
Share
4 Min Read
workers comp ICD10 his
SHARE

workers comp ICD10 hisAll medical providers are preparing to switch their billing practices from ICD-9 coding to ICD-10 as mandated by the Health Insurance Portability Accountability Act of 1996 (HIPPA).

workers comp ICD10 hisAll medical providers are preparing to switch their billing practices from ICD-9 coding to ICD-10 as mandated by the Health Insurance Portability Accountability Act of 1996 (HIPPA).  The change is to take place on October 1, 2014.

Workers’ compensation commercial insurers are non-covered entities under HIPPA and therefore exempt from the mandate to convert their billing practices to ICD-10.  This has created some confusion and concern as to what the impact will be on processing claims submitted by medical service providers who treat a large number of worker’s compensation patients.

Workers’ compensation programs are state run programs governed by the laws and regulations of each state.  Even though different states have different rules and regulations, all states require employers to provide complete coverage for medical treatment of work-related injuries. Each state sets its own fee schedule and does not allow a medical service provider to bill patients for any balance above and beyond the fee established by that schedule.

More Read

green hospitals

9 Hospitals That Have Introduced Green Initiatives

Best Money-Saving Tips for Health Managers
HR Must Navigate Polarizing Views in Healthcare Workplaces
Should Hospitals Use SASE or Traditional Network Security?
The Technology and Services You Need to Open Your Own Counseling Office

Some states have state-managed insurers and require employers to use them.  Others allow national or local insurers to underwrite the workers’ compensation insurance.  States also have different guidelines concerning the electronic submission of claims and the use of electronic health records (EHR).  It is expected that the insurers in those states who use EHR will adopt the ICD-10 format for processing claims.  The problem comes with smaller insurance companies that do not or cannot currently accept electronic claims.

Some workers’ compensation insurers have already confirmed they will accept electronic claims and adopt ICD-10 for claims processing.  The Centers for Medicaid and Medicare Services (CMS) is working with all non-covered entities, including workers’ compensation insurers, to encourage and assist with transitioning from ICD-9 to ICD-10.

Some of the reasons for using ICD-10 even when not mandated are:

• Medical service providers are required under HIPAA to convert from ICD-9 to ICD-10.  Using two billing systems will not be practical for them.  They will refuse to take worker’s compensation cases if it means having a separate billing system and this will compromise the overall care of injured workers.

• The new system actually provides more detailed billing and specificity about treatment provided.  This provides useful information when developing patterns of care.

Anthem Workers’ Compensation announced it will begin using ICD-10 on October 1, 2014, even though it is a non-covered entity.  In addition to the reasons already stated, some additional reasons Anthem gives for its decision are:

• It is an international billing system that allows consistent billing across borders.

• It lists more diagnoses with more specificity.

• Epidemiological tracking is improved with more specificity.

• Uses current technology and updated terminology.

• Contains detailed information about procedures with details about the anatomical site involved and methods used in treating the condition.

• It allows better tracking of patient outcomes.

One big hurdle to nationwide adoption of ICD-10 billing for workers’ compensation is that the way some state statutes are written, legislative changes will need to be made before the insurers are allowed to fully adopt the new billing system.  Since there are so many advantages to adopting the new system even though exempt, it is expected that within two years, workers’ compensation insurers will be on board and implementing the change.

Image: freedigitalphotos.net

TAGGED: EHR, ICD-10, workers' compensation

Sign Up For Daily Newsletter

Be keep up! Get the latest breaking news delivered straight to your inbox.
By signing up, you agree to our Terms of Use and acknowledge the data practices in our Privacy Policy. You may unsubscribe at any time.
Andy Salmen May 18, 2013
Share this Article
Facebook Twitter Copy Link Print
Share
Previous Article Handling New Patient Leads: When to Call a Lead
Next Article ACA Obamacare Won’t Cause Fast Food Shortage

Stay Connected

1.5k Followers Like
4.5k Followers Follow
2.8k Followers Pin
136k Subscribers Subscribe

Latest News

improve self-esteem to fight depression
7 Ways to Enhance Your Self-Esteem to Fight Depression
Mental Health March 31, 2023
healthy travel tips when visiting Australia
7 Essential Tips to Stay Safe and Healthy Visiting Australia
News March 29, 2023
health risks of dirty mattress
Clean Your Mattress Properly to Avoid Common Health Issues
Health March 29, 2023
eligble for NDIS?
Are You Eligible For NDIS? How To Apply
News March 29, 2023

You Might also Like

workers compensation terms
Health

5 Common Workers Compensation Terms for Injured Employees

February 26, 2023
medical call centers benefits
Wellness

Best Practices for Healthcare Call Centers Should Follow in 2023

February 16, 2023
employee's wellness
Health

How Hospitals and Other Healthcare Providers Can Boost Employee Morale

February 13, 2023
BusinessHospital Administration

What are the Benefits of Hospitals and Clinics Using Expense Management Services?

February 13, 2023
//

We influence million of users and is the most authentic source of information on healthcare business and technology news.

Quick Links

  • About
  • Contact
  • Privacy
Subscribe

Subscribe to our newsletter to get our newest articles instantly!

Follow US

© 2008-2023 HealthWorks Collective. All Rights Reserved.

Removed from reading list

Undo
Welcome Back!

Sign in to your account

Lost your password?