Beginning April 1, use diagnosis code set in place at time of discharge

As part of our ICD-10 transition, BCBSM has determined that we must change our facility guidelines for reporting the diagnosis code on inpatient claims. Effective April 1, 2013, we are asking our facilities to begin using the diagnosis code sets in place on the date of discharge (instead of the date of admission) for inpatient claims.

This change not only meets the mandated requirement for the ICD-10 transition, but it also aligns our billing guidelines with those of other payers and makes us consistent with the Centers for Medicare & Medicaid Services. Even though the ICD-10 implementation is scheduled for next year, we are making this change now to allow time for our facilities to make the necessary adjustments.

We’ve heard from some of our facilities that being consistent in which diagnosis code set to use would make it easier to do business with us and help as we all transition to the new code sets.

For more information about billing, check your provider manual on web-DENIS. For more information about the ICD-10 transition, go to bcbsm.com/icd10.