HHS Announces ICD-10 Final Rules

The U.S. Department of Health & Human Services (HHS) has announced two final rules said to facilitate "the United States' ongoing transition to an electronic health-care environment through adoption of a new generation of diagnosis and procedure codes and updated standards for electronic health-care and pharmacy transactions."

The first final rule involves the replacement of current ICD-9-CM code sets with a new and expanded ICD-10-CM code set. International Classification of Diseases and Related Health Problems, Clinical Modification (ICD) codes are used to identify various medical diagnoses and procedures. ICD codes are used by health-care providers and payors.

The second final rule adopts updated versions of standards for electronic health-care transactions to "promote greater use of electronic transactions," according to an HHS news release.

The compliance date for the ICD-10 code set rule is Oct. 1, 2013.

The development of the two rules are being coordinated because the current electronic transaction standards cannot accommodate the new and much larger ICD-10 set of codes. The ICD codes were expanded to be able to cover a great number of new and future medical conditions and procedures. HHS has called the ICD-9-CM code set "outdated with only a limited ability to accommodate new procedures and diagnoses." ICD-9-CM codes also lack "the precision needed for a number of emerging uses such as pay-for-performance and biosurveillance."

HHS says ICD-10 code sets will "support value-based purchasing and Medicare's anti-fraud and abuse activities by accurately defining services and providing specific diagnosis and treatment information."

To read the final rules in the Federal Register, click HERE.

Subscribe to eMobility

Mobility Management's free email newsletter keeping you up-to-date and informed.

I agree to this site's Privacy Policy