Q: What is the ICD-10 compliance date?
A: October 1, 2013.
Q: Will the transition to ICD-10 be postponed?
A: No. The October 1, 2013 compliance date is firm. There are no plans to extend the deadline.
Q: What does ICD-10 compliance mean?
A: ICD-10 compliance means that all HIPAA covered entities are able to successfully conduct healthcare transactions on or after October 1, 2013 using the ICD-10 diagnosis and procedure codes. ICD-9 diagnosis and procedure codes can no longer be used for healthcare services provided on or after this date.
Q: Will ICD-10 replace Current Procedural Terminology (CPT) procedure coding?
A: No. This change does not affect CPT coding for outpatient procedures. ICD-10 procedure codes are for hospital inpatient procedures only.
Q: Who is affected by the transition to ICD-10? If I don’t deal with Medicare claims, will I have to transition?
A: Everyone covered by the HIPAA must transition to ICD-10 on October 1, 2013, including providers and payers who do not deal with Medicare claims.
Q: Do state Medicaid programs need to transition to ICD-10?
A: Yes. Like all other HIPAA covered entities, state Medicaid programs must comply with ICD-10 by October 1, 2013. CMS is continuing to work with Medicaid programs to help ensure they meet the deadline.
Q: What happens if I don’t switch to ICD-10?
A: Claims for all services and hospital inpatient procedures provided on or after October 1, 2013, must use ICD-10 diagnosis and inpatient procedure codes. (This does not apply to CPT coding for outpatient procedures.) Claims that do not use ICD-10 diagnosis and inpatient procedure codes cannot be processed. It is important to note, however, that claims for service and inpatient procedures provided before October 1, 2013, must use ICD-9 codes even if they are submitted after the compliance date.
Q: If I transition early to ICD-10, will CMS be able to process my claims?
A: No. CMS and other payers will not be able to process claims using ICD-10 until the October 1, 2013, compliance date. However, you should plan to start ICD-10 testing with payers beginning in 2012.
Q: Codes change every year, so why is the transition to ICD-10 any different from the annual code changes?
ICD-10 codes are different from ICD-9 codes. ICD-10 has a completely different structure from ICD-9. Currently, ICD-9 codes are mostly numeric and have 3-5 digits. ICD-10 codes will be alphanumeric and contain 3-7 characters. ICD-10 is more robust and descriptive with “one to many” matches in some instances.
Like ICD-9 codes, ICD-10 codes will be updated every year.
Q: Why is the transition to ICD-10 happening?
A: The transition is occurring because ICD-9 codes have limited data about patients’ medical conditions and hospital inpatient procedures. ICD-9 is 30 years old, has outdated and obsolete terms and is inconsistent with current medical practice. Also, the structure of ICD-9 limits the number of new codes that can be created, and many ICD-9 categories are full. A successful transition to ICD-10 will be vital to transforming our nation’s healthcare system.
9185
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 18–20 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
