What is ICD-10?
ICD-10 was developed by WHO, the World Health Organization. ICD-10 is the tenth revision to the International Statistical Classification of Diseases and Related Health Problems. In the Unites States, it is utilized for reporting deaths in hospital-related scenarios. It has been in place since 1999. ICD-10 is going to replace ICD-9 CM, Volumes One and Two. CM stands for clinical modification.
The next set is the ICD-10 PCS which are the Procedure Code Sets. These will be used in the hospital based systems to identify the various surgical and medical procedures that might be going on in the hospital. It is important to note that all entities covered by HIPPA must comply with using ICD-10. All encounters, procedures, discharges, etc. must use ICD-10 and it is a HIPPA compliant code set. There are some organizations and groups that do not need to comply, but the reality is the vast majority will need to comply because they will not be able to communicate with each other if they are utilizing different versions.
Timeline
- January 16, 2009: The final rule related to ICD-10 was published in 2009. General equivalency mappings and preparing for ICD-10 implementation discussions also began in 2009.
- The initial compliance date was set for October 1st, 2013.
- April 17, 2012: The initial compliance date was delayed until October 1st, 2014.
- 2015: The initial compliance date was delayed again to October 1st, 2015.
The Centers for Medicare and Medicaid Services (CMS) have been completing end to end testing. This testing is done with volunteers to see what the claims and billing would look like. They are also looking at what any rejection codes would look like once ICD-10 is being utilized. The testing is going well and it looks positive that ICD-10 will go forward with an initial compliance date of October 1st, 2015. There is a possibility that providers might have the ability to choose between ICD-9 or ICD-10 for the first 980 days but this is just in the proposal stages in the House and Senate and it does not look like it will be in effect at this time. Currently, ICD-9 is to be utilized until October 1st, 2015 and ICD-10 is to be utilized starting October 1st, 2015 and after.
