What is ICD-10?
The ICD-10 is the new, mandatory standard for reporting diagnosis codes and procedure codes on all health care claims – including those submitted to Medicare. It replaces ICD-9 codes which have been used for nearly 30 years. ICD-9 no longer provides the level of specificity required to accurately report diagnosis and inpatient procedures. All covered entities – those covered by the Health Insurance Portability and Accountability Act (HIPAA) are required to begin using ICD-10 codes on October 1, 2014. Claims submitted with ICD-9 codes after October 1, 2014 cannot be processed.
While ICD-10 has two components ( ICD-10-CM for diagnosis coding and ICD-10-PCS for inpatient procedure coding) for Medicare DMEPOS claims, only the ICD-10-CM is changing. Medicare DME MACS will continue to use HCPCS for DMEPOS procedure coding.
ICD-10 must be used for all health care services.
NOTE: The transition to ICD-10 does not impact CPT (Common Procedural Terminology) coding for outpatient and physician services.
The transition to ICD-10 will change how you do business so you need to prepare now to avoid unprocessable claims after October 1, 2014.
Transition to ICD-10 requires health care providers to assess the impact and to implement a strategy to ensure compliance on October 1, 2014. Everything you do – including the way you submit your claims to CGS will be impacted by the transition to ICD-10 so preparation now is the key to your success. Every corner of the US health care industry will be impacted – regardless of whether you are a large corporation or a small provider office. There is a lot to do in the short time remaining!
An ICD-10 implementation guide is available from CMS at: https://implementicd10.noblis.org
A complete listing of provider resources is available at www.cms.gov/Medicare/Coding/ICD10/ProviderResources.html
ICD-10 Testing
A "National Testing Week" for ICD-10 provider testing is scheduled from March 3, 2014 through March 7, 2104. Testing early will ensure your office and related claims systems are ready for the October 1 transition to ICD-10…and that your claims can be processed.
CEDI (the Common Electronic Data Interchange) contractor is coordinating ICD-10 testing activities. Registration for ICD-10 Testing Week is available at: www.ngscedi.com/ICD/ICD10.htm.
CEDI will offer real-time help desk support during testing week. You should review MLN Matters Number: MM8465
(released 2/27/14) for addition information.
ICD-10 Education
CMS has provided a variety of fact sheets designed to help you with the transition. We have provided links to the information below:
Intro Guide to ICD-10
ICD-10 FAQs
The ICD-10 Transition: An Introduction
ICD-10 Basics for Medical Practices
Talking to Your Vendors About ICD-10: Tips for Medical Practices )
ICD-10 and CMS eHealth: Whats the Connection?
ICD-10 Basics for Small and Rural Practices
In addition to expansive education available through CMSand the CEDI, CGS will also provide education for Jurisdiction C suppliers. Beginning in July 2014, CGS will conduct:
- Ask the Contractor Teleconference: ICD-10 Updates and questions. CGS Administrators Provider Outreach and Education Team will have current education, and be able to answer questions about the ICD-10 transition.
- Medicare Minute: Join CGS Administrators Medicare Director Dr. Robert Hoover, for this short video that hits the high points of the ICD-10 transition.
- Online Education Module: This self-directed course covers the ICD-10 transition details.
- Webinar: Join CGS Administrators Provider Outreach and Education staff for a presentation that covers the top ICD-10 transition topics, as well as time for Q & A.
- Workshops/Seminars: CGS Administrators will include ICD-10 education during in-person presentations leading up to the ICD-10 transition date.
- Spanish Language Education: Look for plenty of Spanish Language ICD-10 education, both printed materials via our daily listservs and webinars available at http://www.cgsmedicare.com/jc/education/webinars_sp.html
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