ICD-9, which is over 30 years old, is currently used for reporting health care diagnosis codes in the United States. ICD-10-CM is the diagnosis classification system developed by the Centers for Disease Control and Prevention and is currently used in many countries. Diagnosis coding under this system uses a different number of digits and some other changes, but the format is very similar to ICD-9-CM.
ICD-10 Compliance Date
The U.S. Department of Health and Human Services (HHS) issued a rule finalizing October 1, 2015, as the new compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10, the tenth revision of the International Classification of Diseases. This deadline allows providers, insurance companies and others in the health care industry time to ramp up their operations to ensure their systems and business processes are ready to go on October 1, 2015.
The rule requires the use of ICD-10 beginning October 1, 2015. The rule will also require HIPAA covered entities to continue to use ICD-9-CM through September 30, 2015.
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ICD-9 codes will no longer be accepted on claims (including electronic and paper) with from dates of service on or after October 1, 2015.
- DME claims containing ICD-9 codes for dates of services on or after October 1, 2015, will be returned as unprocessable. Resubmitting these claims with the appropriate ICD-10 code is required.
- A claim cannot contain both ICD-9 codes and ICD-10 codes. Medicare will reject or deny all claims that are billed with both ICD-9 and ICD-10 diagnosis codes on the same claim.
- For claims with "from" dates of service prior to October 1, 2015, submit with the appropriate ICD-9 codes.
- For claims with "from" dates of service after October 1, 2015, submit with the appropriate ICD-10 codes.
The CMS Medicare Learning Network (MLN) Special Edition (SE)1408 provides additional guidance on billing claims after the ICD-10 implementation.
- Updated CMN and DIF Forms for ICD-10
- Oxygen CMN Form Revision for ICD-10
- Latest ICD-10 News
- CMS ICD-10 Industry Email Updates - Recent Email Update messages
- Provider Resources - Includes links to helpful resources from CMS ICD-10 partners and other organizations
- CMS ICD-10 Frequently Asked Questions
- CMS Sponsored ICD-10 Teleconferences - ICD-10 National Provider Teleconference Call information and transcript
- Road to 10: The Small Physician Practice's Route to ICD-10
- ICD-10 Claims Submission Alternatives
- CMS Letter to Providers about ICD-10 Readiness
- Certificate of Medical Necessity (CMN) and DME Information Form (DIF) Revision for ICD-10
- Ask the Contractor Teleconference Questions and Answers – April 30
- Medicare Fee-for-Service Provider Resources ICD-10
- The ICD-Transition: An Introduction
- ICD Basics for Medical Practices
- Talking to Your Vendors about ICD-10
- Questions to Ask Your Systems Vendors about ICD-10
- Role of Clearinghouses in the ICD-10 Transition
- ICD-10-CM Classification Enhancements
- ICD-10-CM/PCS Myths and Facts
- ICD-10-CM/PCS The Next Generation of Coding
- General Equivalence Mappings Frequently Asked Questions
- ICD-10 Glossary [PDF]
- Helpful ICD-10 Websites and Educational Resources [PDF]
- Using the ICD-10-CM Coding Guide [PDF]
Last Updated Feb 10, 2016