Why Transition to ICD-10?
A directive from CMS requiring healthcare providers, payers, clearinghouses, and billing services to comply with the transition to ICD-10 by 1 Oct 2015, which means:
- All electronic transactions must use Version 5010 standards, which have been required since January 1, 2012. Unlike the older Version 4010/4010A standards, Version 5010 accommodates ICD-10 codes.
- ICD-10 diagnosis codes must be used for all health care services provided in the U.S., and ICD-10 procedure codes must be used for all hospital inpatient procedures.
ICD-10 Facts
- ICD-10 has 69,000 codes—more than 4 times the 17,000 codes in ICD-9. The additional codes will enable practices to be more specific on claims forms in reporting the care provided to patients.
- ICD-10 will affect diagnosis and inpatient procedure coding for everyone covered by Health Insurance Portability Accountability Act (HIPAA), not just those who submit Medicare or Medicaid claims.
- The medical terminology has been modernized and is consistent throughout the code set.
- There are codes that have a combination of diagnoses and symptoms, which improves the specificity of the reporting allowing for more information to be reported to completely describe a condition.
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