1
ICD-10
UPDATE
John Mandujano, PMP CPHIMS
September 2, 2015
2
End-To-End Testing
• WellCare’s Challenge
• A Variety of Healthcare Providers
• Mixed Results
3
Testing With WellCare
• Unfortunately, because we are at our capacity in terms of
testing partners, our clearing house is no longer accepting
test ICD-10 claims and adding additional test partners
jeopardizes our preparedness for the October 1st
implementation, we cannot consider testing with any
additional providers.
• We do not anticipate opening up ICD-10 testing beyond what
has already been planned.
4
WellCare’s Internal Training
• External vendor conducted an ICD-10 Boot Camp (20-hour online
workshop) for new Coders coming onboard.
• Corporate coders who have completed assessments and boot
camp are taking more in-depth courses including 26 hours of CM
training and 32 hours PCS training.
• WellCare Associates are taking a 7-hour online training webinar.
• 1-day onsite workshop for all Corporate Coders.
5
WellCare’s ICD-10 Readiness
• WellCare will be compliant with the Center for Medicare &
Medicaid Services (CMS) rule for ICD-10 readiness beginning
Oct. 1, 2015.
• WellCare's systems will align with guidelines from CMS and
support the following: Claims for all services and hospital
inpatient procedures performed on or after the compliance
deadline must use ICD-10 diagnosis and inpatient procedure
codes.
• WellCare is aligning itself with CMS guidelines and practices for
ICD-10 compliance.
6
Don’t Forget
• Use the correct Code List Qualifier Code for each diagnosis code,
e.g. BK for ICD-9 and ABK for ICD-10.
• When it is appropriate, include an ICD-10 code describing the
external cause of morbidity.
• Order the ICD-10 codes in order of significance.
• www.wellcare.com/provider/resources/ICD_general
7