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ICD-10

ICD-10 Compliance Date

The U.S. Department of Health and Human Services (HHS) issued a rule finalizing Oct. 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 Oct. 1, 2015.

The rule This link will take you to an external website. 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.

Stay up to date on ICD-10!

Sign up for CMS ICD-10 Industry Email Updates This link will take you to an external website.

ICD-9 vs. ICD-10 Billing Guidelines Effective October 1

  • ICD-10 Implementation is date of service driven
  • Claims cannot contain both ICD-9 codes and ICD-10 codes
    • Patients with claims requiring an ICD-9 code and claims requiring an ICD-10 code must be submitted separately
  • Claims submitted with date(s) of service prior to October 1, 2015, must contain appropriate ICD-9 code(s)
    • Bill anesthesia procedures that begin on September 30, 2015 but end on October 1, 2015 with ICD-9 codes and include September 30, 2015 as both FROM and THROUGH date
  • Claims with date(s) of services on/after October 1, 2015, must contain appropriate ICD-10 code(s) only. If claim includes an ICD-9 code, it will deny as unprocessable. Providers must submit a new claim that contains appropriate ICD-10 code(s)

The CMS Medicare Learning Network (MLN) Special Edition (SE)1408 This link will take you to an external website. provides additional guidance on billing claims after the ICD-10 implementation.

Resources

Testing Results

Providers can keep informed of ICD-10 implementation activities by registering for the Noridian Email list.

Last Updated Oct 22, 2015

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