ICD-10: Just the Facts
CMS conference call sets the record straight.
By Lynn Jusinski
Posted on: August 26, 2009
On the Centers for Medicare and Medicaid Services (CMS) conference call dealing with General Equivalence Mappings (GEMs), speaker Pat Brooks, RHIA, senior technical adviser, hospital and ambulatory policy group, Center for Medicare Management, CMS, gave several facts about ICD-10-CM/PCS implementation in general. As these came straight from CMS and provided a bit more insight into ICD-10 implementation, we've chosen to highlight a few below.
Implementation won't be delayed. Brooks was very clear on this, and dissuaded rumors that the implementation date may be pushed back. "Unfortunately, I believe some speakers in the industry talk about maybe this being delayed or postponed or double coding, but let me make very, very clear to you that the HIPAA final rule states that this is a firm implementation date of Oct. 1, 2013," Brooks explained.
ICD-9 codes likely won't be accepted. After ICD-10 implementation, due to the edit setup of both Medicare and other insurers, Brooks saw it as unlikely that ICD-9 codes will be accepted at all after Oct. 1, 2013. "If you were to choose the wrong coding system after that time, these claims could be returned so that you would have to put down the correct code," she said.
ICD-10 codes won't affect providers who use CPT and HCPCS codes. Those two code sets will continue to be used after the implementation of ICD-10 without any hiccups in those two systems.
The new code set will be for the date of service on Oct. 1, 2013 and beyond. "Any patient who walks into an ambulatory care or physician office on Oct. 1, 2013, beginning with that date for those encounters, you will begin coding and reporting ICD-10-CM Diagnosis Codes," Brooks noted. "For discharges of inpatients--beginning on Oct. 1, 2013 discharges--hospitals will begin using ICD-10-CM for diagnosis and [ICD-10-PCS] for procedure reporting."
Updates to ICD-10 have been ongoing. Each year, the ICD-9 code set has been updated. CMS has also been keeping an eye on ICD-10 codes, so the number of ICD-10 codes changes every year as the coding system is updated.
CMS would like your input. Brooks appealed to those in the industry for help on deciding whether or not the updates to the ICD-9 and ICD-10 coding systems should be frozen in preparation for the switchover. "Should there be a freeze? And, if so, should it be of both ICD-9 and ICD-10? One or the other? When should the freeze begin?" Brooks asked.
This will be discussed at the ICD-9 Coordination and Maintenance Committee meeting, which will be held Sept. 16-17, and telephone lines will be available for those who can't make the trip to Baltimore.
ICD-10 has much more detail than ICD-9. You probably knew that already, but Brooks gave the exact number of codes available for the 2009 version of each code set. The ICD-9-CM Diagnosis Codes are made up of 14,025 codes. In ICD-10, the equivalent set contains 68,069. When it comes to procedure codes, ICD-9-PCS contains a bit less than 4,000 codes, while ICD-10-PCS has 72,589 codes, a big difference.
Lynn Jusinski is an associate editor with ADVANCE.
Continue to the next page for links to information on ICD-10 and the ICD-9 Coordination and Maintenance Committee meeting.
ICD-10: Just the Facts
1 | 2