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From Health Law Daily, September 15, 2015

New ICD-10 resources provide state progress and information

By Bryant Storm, J.D.

Two new resources designed to ensure a seamless transition to the new ICD-10 code sets are available from the Workgroup for Electronic Data Interchange (WEDI). The resources, an ICD-10 State Workers’ Compensation Readiness List and a List of State Medicaid Sites with ICD-10 Information, are intended to help the industry gauge state readiness for the ICD-10 transition and understand specific state requirements for transaction and code set use in the worker’s compensation context.

ICD-10. After multiple delays, the International Classification of Diseases, Tenth Edition, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) compliance date is set for October 1, 2015. The code sets, which will be used to report diagnoses, represent a significant improvement over the existing set, ICD-9. Whereas ICD-9-CM diagnosis codes are comprised of three to five digits, ICD-10-CM diagnosis codes are comprised of between three and seven digits, which allow for more detailed condition classification. The two extra digits allow for identify information regarding things like laterality, associated symptoms, the causes of poisoning, and the trimester of a pregnancy. Although the code set is promising, due to the regulatory and compliance difficulty associated with a switch to a new diagnostic code set, industry readiness remains a concern (see Weathering the storm of ICD-10’s ‘regulatory tsunami’, August 26, 2015).

Worker’s compensation. WEDI explains that while the worker’s compensation industry is increasingly moving towards Health Insurance Portability and Accountability Act (HIPAA) (P.L. 104-191) Transaction and Code Set rules, because the industry is exempt from HIPAA regulations, the industry is in a state of confusion. Without one national standard, the industry is required to navigate state-specific requirements for transactions and code sets. As a result, national and regional payers, providers, and vendors are tasked with a difficult compliance task. The first WEDI resource is designed to reduce the burden on those members of the industry by compiling, in one place, a state worker’s compensation readiness list. The list is intended to show which states have, for worker’s compensation purposes, adopted the new code set and which have not. WEDI indicates that it has written a letter to each state (copying HHS), which requests the status of the state’s transition to ICD-10 so that industry members can develop a transition plan.

State sites. The other resource made available by WEDI is a list of state Medicaid sites with information pertaining to ICD-10. The linked state sites offer information on ICD-10 testing, readiness, and training. The document is intended to serve as a reference to help industry members prepare for the compliance date. The WEDI ICD-10 workgroup site contains additional information designed to assist with understanding the transition and evaluating its progress.

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