On October 1, 2013, medical coding in U.S. health care settings will change from ICD-9-CM to ICD-10. The transition will require business and systems changes throughout the health care industry. Everyone who is covered by the Health Insurance Portability and Accountability Act (HIPAA) must make the transition, not just those who submit Medicare or Medicaid claims. The compliance dates are firm and not subject to change. If you are not ready, your claims will not be paid. Preparing now can help you avoid potential reimbursement issues.
The differences between the ICD-10 code sets and the ICD-9 code sets are primarily in the overall number of codes, their organization and structure, code composition, and level of detail. There are approximately 70,000 ICD-10-CM codes compared to approximately 14,000 ICD-9-CM diagnosis codes, and approximately 70,000 ICD-10-PCS codes compared to approximately 4,000 ICD-9-CM procedure codes.
In addition, ICD-10 codes are longer and use more alpha characters, which enable them to provide greater clinical detail and specificity in describing diagnoses and procedures. Also, terminology and disease classification have been updated to be consistent with current clinical practice.
ICD-10 Implementation Compliance Date
On October 1, 2013, CMS will implement the ICD-10-CM (diagnoses) and ICD-10-PCS (inpatient procedures), replacing the ICD-9-CM diagnosis and procedure code sets.
• ICD-10-CM diagnoses codes will be used by all providers in every health care setting.
• ICD-10-PCS procedure codes will be used only for hospital claims for inpatient hospital procedures.
• The compliance dates are firm and not subject to change.
- There will be no delays.
- There will be no grace period for implementation.
Important, please be aware:
- ICD-9-CM codes will not be accepted for services provided on or after October 1, 2013.
- ICD-10 codes will not be accepted for services prior to October 1, 2013.