BWC's valid and invalid International Classification of Diseases (ICD-9) codes

BWC approves treatment in workers’ compensation claims for specific allowed conditions, which is why we recognize the current version of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) and use its diagnosis codes to identify medical conditions being treated. You must bill the diagnosis code for the condition you are treating and always follow acceptable ICD-9 coding principles.

Even if you know BWC has not formally allowed the condition in the claim, the managed care organization (MCO) has the discretion and responsibility to coordinate treatment and make reimbursement decisions. If you have any questions about the claim status, including diagnosis information, contact the MCO managing the claim or check the claim status online.

BWC accepts V codes for the principal diagnosis on both inpatient and outpatient bills. However, we do not accept E codes for the principal diagnosis, nor do we recognize these codes for allowance or reimbursement purposes.

BWC has established a comprehensive list of invalid (ICD-9) codes, which, for workers’ compensation purposes, are either non-specific or not applicable to work-related injuries. You can download a list of BWC’s invalid ICD-9 codes, or order a copy online.