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ICD-10

For all services delivered after Oct. 1, 2015, ICD-10 codes must be used on all electronic and paper claims. ICD-9 codes will no longer be used – in fact, Medicare and others have already announced that they will reject claims with the incorrect code set sent.

The change to ICD-10, which is required under HIPAA regulations, was originally set for Oct. 1, 2013, delayed until Oct. 1, 2014 and delayed again until Oct. 1 2015 due to industry struggles to implement the new system.

How Will ICD-10 Affect My Practice?

The new version of this code set is vastly different than ICD-9, both in structure and in meaning. Here's a look at what these changes will mean for your practice:

  • Your favorite codes on your office superbills or in your practice management software can no longer be used.
  • Not only are the codes changing (there will be seven positions rather than five), but the code set is expanding from around 13,000 ICD-9 diagnosis codes to around 65,000 ICD-10 diagnosis codes.
  • Coding for inpatient hospital procedures is also changing from ICD-9 to -10, so hospitals are also greatly impacted by this change.

Why the Change?

  • The ICD-9 code set is outdated and running out of space for new codes.
  • The terminology used is from the 1980s and does not accurately reflect the changes in practice, the discovery of new diseases and treatments, and some of the recommended standards of treatment which have become widespread.
  • ICD-9 is no longer capable of capturing important information for public health tracking, research, and improvement; nor can it support the recent needs for biosurveillance.
  • Quality measurement – a key component of changing health care reimbursement models – was stymied by the lack of specificity in the ICD-9 code set.

Next Steps


ICD-10 Article Library

Learn More

  • New! Frequently Asked Questions
    Find answers to all your questions about ICD-10 and how it will impact your practice.
  • ICD-10: How Different Is It?
    Get a look at the increased specificity of ICD-10 and learn why there's no easy way to translate between ICD-9 and -10.
  • How to Prepare for ICD-10
    The change to ICD-10 will have an impact far beyond the placing of a code on a claim. Learn what your practice can do to prepare.

 

 

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