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Scheme Administration

Q: What are ICD 10 codes, and why are they important?

A: ICD 10 diagnosis codes are used in the healthcare industry to properly note diseases on health records, track epidemiological trends, and assist in medical reimbursement decisions.

They need to be included on your claims in order to ensure that payment is made from the correct benefits. It is law for an account received from a doctor, specialist or dentist to reflect the appropriate ICD 10 codes. Schemes received instruction from the Registrar of Medical Schemes not to pay any accounts that do not reflect these diagnostic codes. Your doctor is aware that these codes are a requirement on an account.

Remember: Your health records and claims information will not be disclosed without your consent and are always treated as confidential information.

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