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About the ICD-10 Transition on October 1, 2015

As of October 1, 2015, all providers, hospitals, and facilities must use the new ICD-10-CM for diagnosis reporting and the ICD-10 procedure codes for inpatient procedure reporting on claims. The ICD-10 transition includes the introduction of more than 68,000 new diagnosis codes to be used by all providers, and approximately 72,000 new procedure codes to be used for inpatient hospital services. These new codes will enable greater specificity in service descriptions. The new codes are expected to provide the increased level of detail needed due to advancements in medicine and technology and will bring the United States on par with the rest of the developed world. Concerns that the current ICD-9 terminology and classifications of some conditions are outdated and inadequate have been cited as the primary reasons for the conversion to ICD-10.

About ICD-10 Usage

ICD-10 codes must be used on all HIPAA transactions, including outpatient claims with dates of service—and inpatient claims with dates of discharge—on or after October 1, 2015. This change does not affect CPT® coding for outpatient procedures, but the diagnosis code(s) submitted with the CPT code(s) must be ICD-10.

Blue Cross and ICD-10

We plan to meet all applicable time frames for compliance and will work closely with providers, software vendors, and clearinghouses as they strive for compliance as well. ICD-10 compliance means that claims with a date of service (for outpatient claims) or a date of discharge (for inpatient claims) on or after October 1, 2015, received via a HIPAA transaction must report ICD-10 codes. Claims with a date of service or discharge earlier than October 1, 2015, must report ICD-9 codes. Blue Cross is already engaged with the Blue Cross and Blue Shield Association (BCBSA) and other Blue Plans regarding the transition, and we are actively monitoring industry progress on ICD-10.

CPT® is a trademark of the American Medical Association.

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