ICD-10 Frequently Asked Questions

ICD-10 is the International Classification of Diseases, 10th Edition and consists of two parts:

1. ICD-10-CM (Clinical Modification): for diagnosis coding and uses 3 to 7 digits, replacing the 3 to 5 digits used with ICD-9-CM
2. ICD-10-PCS (Procedure Coding System): for inpatient procedure coding and uses 7 alphanumeric digits, replacing 3 to 4 numeric digits used with ICD-9-CM

• Health care providers
• Insurance payers
• Software vendors
• Clearinghouses
• Third-Party billing services
• Any other organization that submit electronic claims

• Begin implementation planning and budgeting immediately, if you haven't begun already
• Assess the billing and software needs of the medical office
• Coordinate transition efforts with information technology, clinical, and coding staff
• Discuss readiness plans and timelines for full implementation with software vendors and clearinghouses
• Prepare staff for ICD-10 by providing awareness, materials, training and educational resources
• Begin testing your Version 5010 transactions (the transaction standards used for electronic health care claims upgraded from Version 4010)

1. January 1, 2012: Upgrade Version 4010 of electronic health transactions to Version 5010 for electronic claims submitted on or after January 1, 2012 in order to get medical claims paid VERSION 4010 WILL NO LONGER BE ACCEPTED
2. October 1, 2013: Upgrade ICD-9 coding to ICD-10 for services provided on or after October 1, 2013 in order to get medical claims paid ICD-9 WILL NO LONGER BE ACCEPTED

Visit the Official CMS Industry Resources for the ICD-10 Transition at www.cms.gov/ICD10

Sign up for my newsletter!

Join About Medical Office on Facebook|Twitter!