ICD-10 Insurance Settings

WebPT supports the transmission of ICD-10 or ICD-9 codes for any billing partners based on the insurance settings for each payer. The ICD-10 mandate only applies to HIPAA-covered entities, not all payers transitioned to the new code set on October 1, 2015. To accommodate this, WebPT has an insurance setting that allows users to continue using ICD-9 codes for cases involving certain payers.

Insurance Settings Defaults

Some Payer insurance types are set to Auto or Other defaults for ICD-9 codes. All other insurance types (e.g., HMO, PPO, Medicare, EPO, Medicaid, WCOMP, Tricare, Commercial, Medicare Replacement, POS, GEHA, VA, and Employer) have the ICD-10 checkbox automatically selected with a 10/1/2015 effective date. This date can be updated using the calendar icon to select the effective date for a particular payer.

Editing ICD-10 Insurance Settings

Here’s how to edit the ICD-10 and ICD-9 insurance settings:

1. On the Add Insurance and Edit Insurance screens, check or uncheck the ICD-10 Date effective option in the Settings column. By checking this box, you indicate that the payer will accept ICD-10 codes beginning on the date displayed in the field to the right of the checkbox. That date will default to 10/1/2015 for all payers except those with Auto and Other insurance types.
2. To enter a different effective date, click the Date effective field and type in the date the payer began accepting ICD-10 codes.
3. If you would like this payer to continue accepting ICD-9 codes indefinitely, unselect the ICD-10 checkbox.
4. Click Save.

Adding both ICD-9 and ICD-10 Codes to Notes and Cases

In some instances, you may need to add both ICD-9 and ICD-10 codes to a single case. For example, a patient may have primary insurance that accepts ICD-10 codes and secondary insurance that accepts ICD-9.

To accommodate these scenarios, the Add/Edit Case screen allows you to select the patient’s primary and secondary insurances before you choose the diagnosis codes. Then, as shown in the image below, the diagnosis code selector tool will prompt you to select either ICD 9 or ICD-10 codes based on the insurances you’ve entered. If a case requires dual coding, you will see two options for adding codes: one labeled Add new code (which opens the ICD-10 code selector) and one labeled Add ICD-9 code (which opens the ICD-9 code selector).

Why can't I delete the 000.00 Unknown ICD-9 code off a patient's chart?

Please ensure that you have the ICD-10 insurance setting enabled (shown above) and that the effective date is prior to today's date.