Effective October 1st 2015, the Ohio Bureau of Workers’ Compensation (BWC) has updated to the International Classification of Diseases (ICD) from the previous ICD-9 to the new ICD-10 classification system. The ICD is a system for identifying medical conditions using a numeric code for statistical and insurance purposes. With the update, the system has expanded to a seven character, alphanumeric code for each condition, widening the range of conditions that can be identified from 14,000 to 69,000.
The update, however, has also brought expanded opportunities for the BWC to dispute compensation for certain conditions. For example, previously covered conditions may be denied by the BWC or the MCO if the improper ICD Code is used by the medical provider.
The new extended code range requires doctors to be more specific with their code designation when submitting paperwork to the BWC, otherwise conflicts in processing can occur. If the wrong code is submitted, the BWC could perceive that a doctor thinks the injured or sick worker is unable to work due to an unauthorized condition and, as a result, deny compensation.
What Does This Mean for Me?
If you have been injured in Ohio and are collecting workers’ compensation, it is important that you are aware of these new potential conflicts and that you stay in communication with your physician. With the specificity of this new system, illnesses that were once approved under a broader umbrella of conditions may no longer be covered. If you find yourself suddenly stripped of benefits, you may be able to dispute your denied coverage with the help of an experienced legal professional from our firm.
Involved in a compensation dispute with the BWC? Contact Charles Zamora Co., L.P.A. at (614) 344-6822 or complete a free case evaluation form. A Columbus workers’ compensation lawyer from our firm will promptly be in touch with you.