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ICD-10 Updates

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In 2014, the U.S. Department of Health and Human Services (HHS) issued a rule finalizing October 1, 2015 as the compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10. 
We will continue to work to help ensure that our systems, supporting business processes, policies and procedures successfully meet the implementation standards and deadlines without interruption to day-to-day business practices. We will be capable of accepting and processing ICD-10 diagnosis and inpatient procedure codes on the mandated compliance date. 
 
Key Project Information
We have made several key decisions that will guide our implementation strategy and will be useful as you plan your transition to ICD-10.
ICD-10 Claims Processing

ICD-10 Pre-Authorizations and Claims Filing

ICD-10 FAQs for Providers

This FAQ contains educational information about ICD-10, as well as answers to questions about our ICD-10 implementation 
 
Attention Professional Providers! Coding Practice Tool Available
To support ICD-10 readiness with professional providers
, we are offering a free scenario-based coding practice tool designed to give physicians and their coders the opportunity to test their knowledge of the ICD-10 codes set by applying it to medical scenarios. 
 
April ICD-10 Topic: Successful ICD-10 End to End claims testing yield valuable Lessons Learned 
As part of our approach to discovering, understanding and predicting the impact of ICD-10, we’ve conducted extensive End to End Testing with selected providers and clearinghouses. Here’s what we learned: 
Lesson Learned #1: We are able to accept and deliver electronic claim files with ICD-10 codes through our EDI gateway. We successfully tested with 13 clearinghouses and received 91% of the claims submitted for testing. 
Lesson Learned #2: We can process claim files with ICD-10 codes on all claims systems tested. We successfully tested with the five (5) local claims platforms that support our 14 Blue Markets and the two (2) national platforms, FEP and NASCO. We we able to process over 6,900 test claims submitted by providers. Claim edits performed as expected in our test environment. 
Lesson Learned #3: Our systems can process preauthorizations containing ICD-10 codes. Our care management team conducted a successful testing effort with providers. Preauthorizations processed with no issues. 
Lesson Learned #4: From a medical management perspective, there was virtually no impact due to ICD-10 codes. Claims were reviewed for pay/pend/deny status to see if this would change with using ICD-10 codes. No changes were found. 
For more details on the End to End Testing, read our ICD-10 End to End Testing Summary  
 
ICD-10 Implementation Resources to assist you
Suggested resources to help with your ICD-10 transition and prior Monthly ICD-10 Topics. 
 
Contact Us
For ICD-10 questions and surveys, email us at ICD10-Inquiry@anthem.com  
 
 
 
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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Com pany. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem Web sites constitutes your agreement with our Terms of Use