Offices of the Insurance Commissioner

OFFICES OF THE INSURANCE COMMISSIONER

ADMINISTRATIVE NOTICE 2015-01

TO: All West Virginia Workers’ Compensation Managed Health Care Plans

RE: Semi-Annual Reporting Requirements

The purpose of this notice is to inform you of certain changes being made with respect to the required content of the Managed Health Care Plan semi-annual report set forth in W. Va. CSR §85-21-11 regarding the reporting of injuries and diseases treated per ICD-9 codes.

The Offices of the Insurance Commissioner (OIC) has recently reviewed the reporting requirements set forth in 85 CSR 21 in light of the federally mandated transition to the tenth edition of the International Classification of Diseases (“ICD-10”) which has an initial compliance date of October 1, 2015 as set forth in 45 CFR 162.

In view of the scope and magnitude of the update and transition from ICD-9 to ICD-10 codes, it has been determined that completing the semi-annual report in its current format, which requires extensive reporting of injuries and diseases by ICD codes, would create an undue burden on both managed health care plans and the OIC with respect to the compilation and assimilation of the current reporting information utilizing ICD codes during this transition period.

Accordingly, the semi-annual report format has been temporarily revised to alleviate the ICD code reporting requirements beginning with the reporting period July 1, 2015 through December 31, 2015 and due January 31, 2016. The revised form is attached and may be found at http://www.wvinsurance.gov/ManagedHealthCarePlans.aspx. The use of the revised report will continue until further notice.

Managed health care plans will be expected to otherwise comply with the ICD-10 reporting requirements, as applicable, which will be set forth in Informational Letter No. 195.

If you have any questions concerning this Administrative Notice, please contact:

Bob Rodak – ph. 304-558-6279 ext.1261; email:

For information regarding Semi-Annual Report Form contact:

Carrie Ford – ph.304-558-6279 ext.1230; email: or

Kathy Stuck- ph.304-558-6279 ext.1234; email:

Issued: August 3, 2015