On October 1, 2014, the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets.
- Everyone covered by HIPAA must transition to ICD-10. This includes providers and payers who do not deal with Medicare claims as well as state Medicaid programs.
- The switch to ICD-10 does not affect CPT coding for outpatient procedures. Like ICD-9 procedure codes, ICD-10 PCS codes are for hospital inpatient procedures only.
- ICD-10 codes are different from ICD-9 codes and have a completely different structure. Currently, ICD-9 codes are mostly numeric and have 3 to 5 digits. ICD-10 codes are alphanumeric and contain 3 to 7 characters. ICD-10 is more robust and descriptive with “one-to-many” matches in some instances.
- Providers should plan to test their ICD-10 systems early, to help ensure compliance. Beginning steps in the testing phase should include internal testing of ICD-10 systems, coordination with payers to assess readiness and a project plan launch by data management and IT teams.