ICD-10 Upgrades the Worker Compensation Process

For the last thirty years, the United States’ healthcare industry has operated within the codes and procedures of the World Health Organization’s International Classification of Diseases (ICD-9). In October of 2015 however, the federal government mandated an upgrade to the most current version, ICD-10.

What is ICD-10?

What is ICD-10?

This coding update increased the number of health conditions from fourteen thousand to nearly seventy thousand in order to streamline the claims process.

It includes everything from machinery injuries to overexertion to chronic conditions.  If you’re a Massachusetts worker looking for information about compensation after an injury on the job, how does this change impact you? Before this code change took place, the process of filing a claim for a workplace injury was more generalized and vague. Your physician would:

  1. Take note of your injuries
  2. File a primary diagnosis
  3. Add a secondary diagnosis, documenting the injury as a result of working conditions.

Under ICD-9, this claim was titled “Adverse effects of work environment” (V62.1).

How Has It Changed?

Now under ICD-10, your physician just needs to find a much more specific code, depending on your work environment and role. Some new codes include:

  • Occupational Exposure to Noise (V57.0)
  • Occupational Exposure to Risk Factors (V57.8)
  • Occupational Exposure to Environmental Tobacco Smoke (V57.31)

Hearing damage from working as a contractor in construction and breathing issues from bartending in a casino now fall under different codes, allowing for a quicker response time by health administrators who no longer need to interpret unclear documentation.

The Results?

As the RAND Corporation predicted in a cost-benefit study, ICD-10 has resulted in fewer miscoded claims, rejected claims, and improper reimbursement claims, decreasing the time necessary to compensate injured workers.

Help Your Physician Help You

This new system means a faster turnaround time for your work-related injury claim.

In order to further expedite the process, here are a few tips for providing your physician with the most accurate description of your injury possible:

Write it Down: Different injuries can affect your memory over time, so make sure to keep a clear record of the incident, as well as what caused it.

Check for Symptoms: Adverse work conditions can trigger unexpected, and often unnoticed, symptoms. If you’re hurting and don’t know why, tell your physician immediately.

Avoid Self-Medicating: Treating yourself for a serious injury or condition without consulting a professional can significantly exacerbate medical problems in the long run.

Contact a Workers Compensation Attorney

Sometimes you can do everything right and still hit a dead end.

If your insurance company refuses to pay for an illness or chronic condition sustained while working, you may wish to seek the advice of an experienced workers’ compensation attorney to determine if your claim is being unlawfully denied.

Do you have questions about workers’ compensation?

Our experienced attorneys can help. Contact us to talk about your case and to learn more about your options.