International Classification of Diseases (ICD) - 10
On March 1st 2014 ONC and the federal government changed the release date for ICD-10. The date was previously set for October 1, 2014, and it is now delayed one year to October1, 2015. The ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets at that time.
The transition to ICD-10 is required for everyone covered by the Health Insurance Portability Accountability Act (HIPAA). Please note, the change to ICD-10 does not affect CPT coding for outpatient procedures and physician services.
The ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets. This fact sheet provides background on the ICD-10 transition, general guidance on how to prepare for it, and resources for more information.
About ICD-10 - ICD-10-CM/PCS (International Classification of Diseases, 10th Edition, Clinical Modification /Procedure Coding System) consists of two parts:
ICD-10-CM is for use in all U.S. health care settings. Diagnosis coding under ICD-10-CM uses 3 to 7 digits instead of the 3 to 5 digits used with ICD-9-CM, but the format of the code sets is similar.
The transition to ICD-10 is occurring because ICD-9 produces limited data about patient's medical conditions and hospital inpatient procedures. ICD-9 is 30 years old, has outdated terms, and is inconsistent with current medical practice. Also, the structure of ICD-9 limits the number of new codes that can be created, and many ICD-9 categories are full.
Sign up for ICD-10 Email Updates and follow @CMSgov onTwitter for the latest news and resources.Visit www.cms.gov/ICD10 for ICD-10 and Version 5010 resources from CMS.
Health care providers, payers, clearinghouses, and billing services must be prepared to comply with the transition to ICD-10, which means:
The move to ICD-10 is one of the biggest challenges for the healthcare industry in our lifetime. Our team will support you through all phases of this critical change ? from preparation to the initial transition and adjustment period. We have updated our systems to transmit ICD-10 codes and will help you make a smooth transition by:
Our partner Clearinghouse Gateway EDI/Trizetto will continue to accept ICD-9 and 4010.
We will continue to allow claims to be submitted in legacy formats such as print image, NSF and 4010 through A.I.med. We will continue to send ICD-9 codes to payers who are not ready for the new code set on October 1, 2015.
Our knowledgeable EDI specialists will be available to answer any questions you have about the testing process.