ICD-10

Resource Center

Welcome to MedeAnalytics’ ICD-10 Resource Center! This online resource provides a complimentary educational service to the healthcare industry.

International Classification of Diseases, 10th Edition, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) consists of two parts: ICD-10-CM for diagnosis coding; and ICD-10-PCS for inpatient procedure coding.

ICD-10-CM is for use in all U.S. healthcare settings. Diagnosis coding under ICD-10-CM employs 3 to 7 digits instead of the 3 to 5 digits used with ICD-9-CM, but the format of the code sets is similar. ICD-10-CM is comprised of more than 69,000 diagnosis codes, while ICD-9-CM contains about 13,000.

ICD-10-PCS is for use only in U.S. inpatient hospital settings. ICD-10-PCS employs 7 alphanumeric digits instead of the 3 or 4 numeric digits used under ICD-9-CM procedure coding. Coding under ICD-10-PCS is much more specific and substantially different from ICD-9-CM procedure coding. ICD-10-PCS has more than 72,000 codes.

Why the change to ICD-10? ICD-9 produces limited data about patients’ medical conditions and hospital inpatient procedures. As ICD-9 is 30 years old, it has outdated terms and is inconsistent with current medical practice. In addition, the structure of ICD-9 limits the number of new codes that can be created, and many ICD-9 categories are full.

ICD-10 will affect diagnosis and inpatient procedure coding for everyone covered by the Health Insurance Portability and Accountability Act (HIPAA), not just those who submit Medicare or Medicaid claims. Everyone covered by HIPAA who transmits electronic claims must also switch to Version 5010 transaction standards. The change to ICD-10 does not affect CPT coding for outpatient procedures.

The deadline for implementation of ICD-10 has been delayed previously. In January 2009, the date was pushed out by two years, from Oct. 1, 2011 to Oct. 1, 2013. On Feb. 14, 2012, CMS Acting Administrator Marilyn Tavenner told reporters at the AMA's National Advocacy Conference in Washington, D.C. that CMS would "re-examine the timeframe" for ICD-10. On Feb. 16, 2012, HHS Secretary Kathleen Sebelius announced that the department would initiate a rulemaking process to push back the ICD-10 compliance deadline from Oct. 1, 2013 to an unspecified later date. On April 5, 2012, HHS published a rule that proposes a one-year delay, changing the compliance date for ICD-10 from Oct. 1, 2013 to Oct. 1, 2014. Then on Aug. 24, 2012, HHS published a 208-page final rule that confirmed Oct. 1, 2014 as the compliance date for ICD-10.

Given the complexity and magnitude of the work involved in ICD-10 conversion, we encourage you to visit this resource center often to keep abreast of the latest salient developments in the ICD-10 area.


Featured ICD-10 Resource