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BCBSIL Response to Recent CMS Guidance on ICD-10

Posted September 16, 2015

On July 6, 2015, the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association jointly announced a plan intended to help ease the transition to ICD-10. CMS has provided further guidance to clarify that the transition period is intended to allow for flexibility in the claims auditing and quality reporting process for Medicare Part B fee-for-service physician claims only. While it may be interpreted (incorrectly) that CMS is offering a grace period with relaxed requirements, it is important to note that there is no extension extended or permitted to commercial payers and the compliance date of Oct. 1, 2015 for use of ICD-10 remains the same

As a commercial payer, Blue Cross and Blue Shield of Illinois (BCBSIL) has diligently worked to be prepared to meet mandated ICD-10 timelines and requirements. System and business process changes to accommodate ICD-10 transactions have been completed and we intend to maintain our current approach regarding the transition to ICD-10. As announced previously, valid ICD-10 codes must be included on claims submitted to BCBSIL for dates of service/inpatient discharge dates on and after Oct. 1, 2015. BCBSIL is not permitted to accept claims without required valid ICD-10 codes and such erroneous submissions will not be accepted by BCBSIL. 

We will continue to monitor industry news for additional guidance/clarifications. Please watch the Blue Review, as well as the News and Updates for general information, announcements and related resources.