Monday, September 21, 2015

ICD 10 is Here According to the Florida Division

The following is directly from a Division of Workers' Compensation notification and is all quoted verbatim. 

On October 1, 2015 the Centers for Medicare & Medicaid Services (CMS) will be transitioning to ICD-10 (diagnosis coding).  In line with the CMS policy, the Division of Workers' Compensation will require ICD-10 codes for medical bills and medical EDI transactions containing dates of service on or after 10/1/15.  The Division will require ICD-9 codes on medical bills and medical EDI transactions with dates of service prior to 10/1/15.

In an effort to promote the self-executing nature of the workers' compensation system, the Division urges all interested parties to consider Rule 69L-7.710(5)(j)1.a., F.A.C. in securing correct diagnosis codes.  The rule states, in part, the insurer, service company/TPA, or entity acting on behalf of the insurer can:

"Secure and/or correct the information on the medical bill and proceed to make a reimbursement decision to pay, adjust, disallow, or deny billed charges within 45-calendar days from the "date insurer received".


If you have any questions or concerns please contact the Medical Services Section at Workers.MedService@myfloridacfo.com

Ed Note: What does this mean, here is a good post on the effects of ICD10