ICD-10

About

In 2009, the U.S. Department of Health and Human Services (HHS) issued a final rule to move from the currently used International Classification of Diseases (ICD-9) to the next generation of ICD-10 code sets by October 1, 2013. In April 2012, HHS proposed to delay the ICD-10 compliance date by one year, until October 1, 2014.

Compliance Dates

• January 1, 2012: In order to support the new ICD-10 codes, all health care entities (health care providers, health care clearinghouses, health plans, etc.) must first adopt the new HIPAA 5010 standards by January 1, 2012. However, CMS has announced a grace period for this rule. Please visit the HIPAA 5010 web page for more information on the transition.
• October 1, 2013: All outpatient claims with a date of service on or after October 1, 2013, must be submitted with ICD-10 codes and all inpatient claims with discharge dates on or after October 1, 2013, must be submitted with ICD-10 codes. Claims that are submitted with non-compliant codes after this date will be rejected.

How to Prepare

Providers should prepare for ICD-10 by first ensuring they are in compliance with HIPAA 5010, a prerequisite for the conversion to ICD-10. Physician practices and facilities can then create an ICD-10 implementation plan that includes an awareness campaign and an education strategy.

What Will Change

• Diagnosis codes (ICD-10-CM) and procedure codes (ICD-10-PCS) will have more digits; CPT and HCPCS codes will not be affected.
• The number of codes will increase significantly from roughly 14,000 codes to 170,000 codes.
• The new ICD-10 codes:
  • use updated and more precise medical terminology;
  • enable laterality;
  • allow for the ability to add new codes;
  • include greater specificity (including a greater number of digits);
  • provide more detailed clinical information about conditions, diseases, and injuries.

The implementation of ICD-10 will result in more accurate coding, which will improve the ability to measure health care services, enhance the ability to monitor public health, improve data reporting, and reduce the need for supporting documentation when submitting claims.

Please visit this site frequently for updated information on ICD-10.

Frequently Asked Questions About ICD-10

Please refer to the following document for additional information about the transition to ICD-10.

Frequently Asked Questions about ICD-10