Notices and Announcments

ICD-10 ‘Coding Basics’ Video and Other Resources
While it may take time for providers, payers, clearinghouses and other vendors to adjust completely, it appears that the national transition to ICD-10 has been largely successful.

The Centers for Medicare & Medicaid Services (CMS) continues to release educational resources for providers, such as a recent video titled, “ICD-10 Post-Implementation: Coding Basics Revisited.” This video covers such points as the CMS definition of a valid code, basic guidelines for coding and reporting on claims, as well specific examples (7th character, unspecified codes, external cause codes, laterality, etc.) and information on resources for coders. The 33-minute video features American Health Information Management Association (AHIMA) Senior Director of Coding Policy and Compliance Sue Bowman, MJ, RHIA, CCS, FAHIMA, and Nelly Leon-Chisen, RHIA, from the American Hospital Association (AHA).

The Coding Basics Revisited video may be accessed via the CMS website at cms.gov/icd10. For your convenience, a link to the video also is posted in the Standards and Requirements/ICD-10 section of the Blue Cross and Blue Shield of Texas (BCBSTX) provider website. You’ll also find links to other ICD-10 resources on our Provider website, such as updated answers to frequently asked questions.

This material is for educational purposes only and is not intended to dictate what codes should be used in submitting claims. Health care providers are instructed to use the most appropriate codes based upon the medical record documentation and coding guidelines.

BCBSTX Behavioral Health Quality Improvement Program
BCBSTX is committed to improving our members’ experience and the value they receive from behavioral health care delivery. To meet these goals, BCBSTX identifies, monitors and evaluates clinical and service improvement opportunities through the Behavioral Health Quality Improvement (BHQI) program.

BHQI reviews behavioral health care management and quality improvement programs annually to assess progress toward identified goals as well as the overall effectiveness of the behavioral health program. BHQI has helped improve quality of care for our members by implementing programs that:

• Help ensure that members are able to make and keep provider appointments after a hospitalization;
• Verify that expectant mothers have received depression screenings and appropriate treatment;
• Connect members with resources in their community that may provide additional support; and
• Improve care coordination between members’ primary care physicians and specialists.

To ensure we are providing optimal service to our members, BHQI tracks whether members and providers have suitable phone access to BCBSTX and whether members have appropriate behavioral health provider network options in their geographic areas. BHQI also responds to complaints and quality of care concerns regarding the behavioral health program or behavioral health providers.

The BCBSTX behavioral health program is accredited by nationally recognized health care quality organizations, including the Utilization Review Accreditation Commission (URAC) and the National Committee for Quality Assurance (NCQA). For more information about the BHQI program, email bhqualityimprovement@bcbstx.com.