Blue Cross Blue Shield of Mississippi
Childhood Obesity Program

Countdown to ICD-10 Implementation

ICD-10 is here, Blue Cross & Blue Shield (BCBSMS) is prepared to transition to ICD–10. Are you? In order to ensure a smooth transition to ICD–10, please take note of the following:

1. ICD–10 Claim Guidelines

When submitting claims, please keep the following in mind:

Professional Claims

Outpatient Institutional Claims

Inpatient Institutional Claims

2. Medical & Coding Policy Changes

ICD–10 updated Medical and Coding Policies have been published to allow your staff ample time to review prior to the transition. The updated Coding Policies include Healthy You! Coding Guidelines, H1N1(Swine–Flu Vaccine) and Medically Indicated Early–Term Deliveries (Prior to 39 Weeks) Coding Guidelines.

The Medically Indicated Early–Term Deliveries (Prior to 39 Weeks) Coding Guidelines have been updated to include the weeks of gestation and delivery outcome on both professional and facility delivery claims effective October 1st. The type of labor, delivery method and the number of deliveries associated with the delivery method are also required on the professional delivery claim however, coding will be optional until January 1, 2016 to allow you time to get acclimated to the coding guidelines. The clinical diagnosis information will serve the purpose of identifying, evaluating, and developing initiatives that align with best practice obstetric care. It is important to closely review the Medically Indicated Early–Term Deliveries (Prior to 39 Weeks) Coding Guidelines prior to submitting delivery claims on or after October 1st to avoid claims disruption.

3. Importance of Diagnosis Codes

The new ICD–10 code sets have the potential to provide more detailed data as to diagnoses. The additional detail will also assist with identifying patients who are eligible for disease management programs. To ensure your claims are coded accurately, each diagnosis code from an episode of care must be provided on the claim. It is important that all physicians, medical coders as well as office staff, are trained on how ICD–10 codes should be used. BCBSMS will accept all patient diagnosis codes submitted on a claim – as such, please include every diagnosis code on your claims.

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