Employers will soon have to adopt a new system for coding and reporting workplace injuries and illnesses that could help them improve their claims reimbursement rates. Effective Oct. 1, 2015, all entities covered under the Health Insurance Portability and Accountability Act (HIPAA) will be required to use the International Classification of Diseases, Modification, and Procedural Coding Systems (ICD-10) to report injuries and illnesses to the Centers for Medicare & Medicaid Services (CMS). CMS has directed that responsible reporting entities—including workers' compensation insurers and claims administrators—also need to adopt ICD-10. Employers need to understand how ICD-10 affects them and how they can ensure that their claims administrators and reporting agents comply with the new rule.

ICD-10 versus ICD-9

Currently, non-group health plans are required to use ICD-9 codes to report workers' compensation-related injuries to CMS, which has become an outdated method of classifying injuries and illnesses. Because new injuries and illnesses cannot be added to the system, CMS often has insufficient information about the specific nature of injuries and illnesses. This has contributed to a reduction in reimbursement to workers' compensation payers over the last several years.