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ICD-10 Compliance

On April 1, 2014, President Obama signed into law a bill enacting the Protecting Access to Medicare Act of 2014. 

The Center for Medicare & Medicaid Services (CMS) has communicated that they are examining the implications of the ICD-10 provision in the Bill in order to provide guidance to providers and stakeholders.

The provision in the statute reads as follows: "The Secretary of Health and Human Services may not, prior to Oct. 1, 2015, adopt ICD-10 code sets as the standard for codes sets under section 1173 (c) of the Social Security Act (42 U.S.C. 1320d-2 (c)) and section 162.1002 of title 45, Code of Federal Regulations." 

WellCare Health Plans will continue to monitor CMS' communications on ICD-10 while proceeding with plans to conduct ICD-10 external testing. We will continue to provide updates on our provider website on potential impacts to our plan and implementation timelines as more information becomes available.


We are aligning with CMS guidelines and practices for ICD-10 compliance. Please refer to these resources for more information about CMS ICD-10 initiatives and resources.


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Last Updated On: 9/17/2015