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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

September 2015

ICD-10 Transition Approaching


Harvard Pilgrim has been working hard to ensure operational readiness for the long-awaited transition to ICD-10 code sets. We have completed systems work and have updated our medical and payment policies to include ICD-10 coding. Harvard Pilgrim is prepared to embrace the implementation of these codes, and we are here to help make the process as seamless as possible for providers. 

With the October 1, 2015 compliance date approaching, Harvard Pilgrim is offering the following tips and information to help you with the transition from ICD-9 to ICD-10 codes:

  • Harvard Pilgrim is now accepting referrals, prior authorization requests, and inpatient notifications requiring ICD-10 codes with requested dates of service on or after the October 1 implementation date.
  • Refer to our FAQ for providers for specific guidance on appropriate coding and answers to common questions regarding the move to ICD-10 code sets.
  • If you use paper claims, submit the applicable ICD indicator on the claim form to identify whether ICD-9 or ICD-10 codes are being reported. This article from last month’s issue of Network Matters provides more detail about submitting ICD indicators for paper claims. For additional information, please see the Paper Claims section of our Provider Manual. For information on electronic claims filing, which we recommend to all providers for its ease of use and accuracy, please see the Electronic Claims section of our Provider Manual.  
  • Be sure to visit the Preparations for ICD-10 page on Harvard Pilgrim’s provider website for additional resources.

Get your questions answered at our call-in forums

Understanding the challenges of shifting from ICD-9 to ICD-10 coding, Harvard Pilgrim has developed a comprehensive plan to assist providers and answer any questions you may have throughout the transition. In addition to monitoring for claim rejection issues and working with providers to resolve them, Harvard Pilgrim will be offering weekly call-in forums where providers and office staff can ask ICD-10 questions or discuss issues with Harvard Pilgrim staff. No registration is required; simply call 888-687-4838 and enter participant code 19050791#. The forums will be conducted from 8:30 a.m. to 9:30 a.m. on the following Thursdays: Oct. 8, Oct. 15, Oct. 22, Oct. 29, Nov. 5, Nov. 12, Nov. 19, and Dec. 3.

For questions regarding electronic transactions and ICD-10, contact the Harvard Pilgrim EDI Team at EDI_Team@harvardpilgrim.org or
800-708-4414 (select option 1, then press 3). For claims issues, please contact the Provider Service Center at 800-708-4414 or your Provider Relations Consultant.

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PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Vice President, Network Services

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Editor

Joseph O'Riordan,
Writer

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Production Coordinator