Introduction to ICD-10
The ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets on October 1, 2015. ICD-10 will affect diagnosis and inpatient procedure coding for everyone covered by the Health Insurance Portability Accountability Act (HIPAA), not just those who submit Medicare or Medicaid claims.
Overview of ICD-10 – What is ICD-10?
Developed over ten years with input from many stakeholders, mostly professional societies, ICD-10-CM extends the 14,400 WHO codes to 69,823 codes. The United States version of ICD–10–CM is maintained by the Centers for Disease Control and Prevention (CDC). (https://www.cdc.gov/)
ICD-10 provides more specific data than ICD-9 and better reflects current medical practice. The added detail embedded within ICD-10 codes informs health care providers and health plans of patient incidence and history, which will improve the effectiveness of case management and care coordination functions. Accurate coding reduces the volume of claims rejected due to ambiguity.
Transition to ICD-10
On October 1, 2015, all covered entities, as defined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Administrative Simplification, are required to adopt ICD-10 diagnosis codes for services provided beginning on October 1, 2015. For inpatient encounters, ICD-10 procedure codes will be required to be used for all stays with discharge dates on or after October 1, 2015. The transition to ICD-10 procedure codes for inpatient encounters does not directly affect outpatient service providers’ use of the Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes.
Are you preparing for ICD-10?
- Click here for Provider Notification for ICD-10 Implementation for Prior Authorization and Claim Process
- Click Here for ICD-10 Provider Notification
- Click Here for CalOptima ICD-10 Information
- Click Here for ICD-10 Code Translator
- Click Here for ICD-10 Resources
- Click Here for CHA Top 30 Pediatric ICD-9 to ICD-10 Codes