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ICD10 Codes Required for Dates of Service Beginning October 1, 2014

Blue Cross and Blue Shield of North Carolina (BCBSNC) is preparing for the health care industry’s conversion to the 10th version of the International Classification of Diseases code set (ICD-10).  In compliance with HHS regulations, all HIPAA-covered entities are required to use ICD-10 on all transactions, including claims, authorizations, referral requests, and verification of benefits and eligibility.  The industry-wide conversion to ICD-10 will occur on October 1, 2014. 

BCBSNC is taking the necessary steps to ensure that all of its systems and processes will accommodate ICD-10 by the federal compliance date.  All electronic or paper-based transactions for services on or after October 1, 2014, must contain ICD-10 codes or they will be rejected. 

Under the Administrative Simplification provision requirements, if providers use ICD-9 codes in transactions for services or discharge dates on or after October 1, 2014, the claim will be rejected as noncompliant, and the transaction will not be processed.  Therefore, providers may experience disruptions in transactions being processed and receipt of payments if they submit noncompliant transactions. 

BCBSNC urges all HIPAA-covered entities to be fully prepared for ICD-10 implementation.  ICD-10 implementation will change how a practice operates.  Any business process or technology that stores, processes, or utilizes medical/diagnosis/procedure codes will be affected on some level. 

BCBSNC will be ICD-10 compliant on October 1, 2014.  In accordance with the federal mandate, please note the following: 

  • Claims submitted to BCBSNC with dates of service or discharge dates on or after October 1, 2014, must be submitted with the appropriate ICD-10 code (ICD-10 codes as of October 1, or ICD-9 codes for dates of service prior to October 1).
  • BCBSNC WILL NOT accept claims with ICD-9 codes for dates of service on or after October 1, 2014.  These claims will not be paid until they are submitted with the correct ICD-10 codes.
  • Provider noncompliance will increase business disruption for provider billing staff and for BCBSNC, as well as disrupt provider revenue stream.

For more information and additional ICD-10 resources, please visit BCBSNC’s Countdown to ICD-10 Compliance website.