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 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 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
- ICD-10 implementation is date of service driven
- Claims cannot contain both ICD-9 and ICD-10 diagnosis codes on same claim, such claims will Returned to Provider (RTP)
- Claims cannot contain both ICD-9 and ICD-10 procedure codes on same claim, such claims will RTP
- Claims submitted with date(s) of service prior to October 1, 2015, must contain appropriate ICD-9 code(s)
- Claims with date(s) of services on/after October 1, 2015, must contain appropriate ICD-10 code(s) only. If a claim includes an ICD-9 code, it will RTP as unprocessable. Providers must submit a new claim that contains appropriate ICD-10 code(s)
- Split Claims – Will require providers to split claims so all ICD-9 codes remain on one claim with dates of service through September 30, 2015 and all ICD-10 codes placed on another claim with DOS beginning October 1, 2015 and later
The CMS Medicare Learning Network (MLN) Special Edition (SE)1408 provides guidance for claims that span the ICD-10 implementation date. We encourage providers to share this information all staff.
- CMS Latest News
- CMS Teleconferences
- Provider Resources (FAQs, guides, checklists, etc.)
- Medicare Fee-for-Service Provider Resources ICD-10
- ICD-10-PCS Official Guidelines for Coding & Reporting-2015
- AMA - ICD-10 Code Set to Replace ICD-9
- Road to 10: The Small Physician Practice's Route to ICD-10
- The ICD-10 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
- CMS Letter to Providers about ICD-10 Readiness
- ICD-10 Glossary [PDF]
- Helpful ICD-10 Websites and Educational Resources [PDF]
- Using the ICD-10-CM Coding Guide [PDF]
- ICD-10 Claims Submission Alternatives
- ICD-10 Round 2 End-to-End Testing Checklist
- July 2015 End-to-End Testing Results
- April 27 - May 1, 2015 End-to-End Testing Results
- March 2015
- January 2015
- November 2014
- March 2014
Providers can keep informed of ICD-10 implementation activities by registering for the Noridian Email list.
Last Updated Apr 13, 2017