As you’ve probably heard by now, the Centers for Medicare and Medicaid Services (CMS) have announced that October 1, 2013 is the date for implementing the ICD-10 system within the United States. Additionally, HHS (Department of Health and Human Services) would adopt the updated X12 standard, Version 5010, and the National Council for Prescription Drug Programs standard, Version D.0, for electronic transactions, such as health-care claims. Version 5010 is essential for using the ICD-10 codes.

While this date is four years away, prudent practices are preparing now for this significant change in our health care reporting system that will impact all practitioners.

ICD-9 vs. ICD-10
In 2000, under authority provided by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the ICD-9-CM code sets were adopted for use in the administrative transactions by both the public and private sectors to report diagnoses and inpatient hospital procedures. Covered entities required to use the ICD-9-CM code sets include health plans, health care clearinghouses and health care providers who transmit any electronic health information in connection with a transaction for which a standard has been adopted by HHS.

Developed almost 30 years ago, the ICD-9 system is now widely viewed as outdated because of its limited ability to accommodate new procedures and diagnoses. ICD-9 contains only 17,000 codes and is expected to start running out of available codes next year. By contrast, the ICD-10 code sets contain more than 155,000 codes and accommodates a host of new diagnoses and procedures. The additional codes will help to enable the implementation of electronic health records because they will provide more detail in the electronic transactions.

The ICD-10 code sets proposed rule would concurrently adopt the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) for diagnosis coding, and the International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) for inpatient hospital procedure coding.

The new ICD-10 code sets will replace the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) Volumes 1 and 2, and the International Classification of Diseases, 9th Revision, Clinical Modification (CM) Volume 3 for diagnosis and procedure codes, respectively. We currently use only the diagnosis coding portion (Volume 3) of the ICD system for our practices.

Start Planning Now
So, what does this mean to you, today? You should be checking regularly with your technology providers (i.e., EMR and practice management software vendors) about what they’re doing to implement the ICD-10 in their systems. Keep in mind that you will most likely have to maintain both the ICD-9 and the ICD-10 systems simultaneously for a one-year period to preserve the one-year retroactive billing process. Also, know that the implementation of the ICD-10 will be a significant cost burden for each of us, and for the health care industry as a whole.

One thing is very clear: It’s never too late to start planning for this very significant change. And, that planning within your practice should begin now! Training of your organization is vital and there are many tools to help make the transition easier. A good place to start: Medicare’s website ( provides a wealth of information regarding the ICD-10.

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