Suppliers Urged to Prepare for ICD-10 Transition

More than three years ago, the U.S. Department of Health & Human services set a timeline for all organizations covered by HIPAA to upgrade to version 5010 by Jan. 1, 2012.

With March 31 of this year as the date for all organizations to complete their version 5010 upgrade, the next big project deadline is Oct. 1, 2013 - the date by which organizations must be transitioned to ICD-10 code sets.

The ICD-10 diagnosis and procedure code sets replace current ICD-9 sets. ICD-9 codes cannot be used for healthcare services provided on or after Oct. 1, 2013 - a compliance date that is firm, according to a Centers for Medicare & Medicaid Services (CMS) Frequently Asked Questions (FAQ) document.

The ICD-10 transition applies to suppliers working with Medicare, Medicaid and all other entities covered by HIPAA.

Suppliers should continue to use the current ICD-9 codes until Oct. 1, 2013, the CMS FAQ document says, as payors won't be able to process claims using ICD-10 codes until the transition takes place.

"It is important to note, however," says the FAQ bulletin, "that claims for services and in-patient procedures provided before Oct. 1, 2013, must use ICD-9 codes even if they are submitted after the compliance date."

ICD-10 codes contain three to seven alphanumeric characters, versus the current ICD-9 codes, which have fewer characters and use mostly numbers. The new code set is designed to be "more robust and descriptive," the FAQ bulletin says, compared to the ICD-9 code set structure, which has a lower limit of codes it can accommodate.

"ICD-9 codes have limited data about patients' medical conditions and hospital in-patient procedures," the bulletin says. "ICD-9 is 30 years old, has outdated and obsolete terms, and is inconsistent with current medical practice."

For more information on the ICD-10 transition and resources to help make the move, go to cms.gov/ICD10/.

About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at lwatanabe@1105media.com.

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