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On October 1, 2015, the U.S. will transition from ICD-9 to ICD-10 as the medical code set for medical diagnoses and inpatient hospital procedures. Health care providers using ICD-9 codes on or after October 1, 2015 will be unable to bill for their services.
ICD-10 consists of two parts:
The federal mandate to transition to ICD-10 pertains to all HIPAA-covered entities including Providers, Payers, Vendors and their business associates:
On July 31st, 2014, the U.S. Department of Health and Human Services (HHS) issued a rule finalizing Oct. 1, 2015 as the compliance date for health care providers, health plans, and health care clearinghouses to use ICD-10, the tenth revision of the International Classification of Diseases. This deadline was intended to allow time for providers, insurance companies and others in the health care industry to ramp up their operations to ensure their systems and business processes are ready to go on Oct. 1, 2015.
The federal mandate to transition to ICD-10 pertains to all HIPAA-covered entities including Providers, Payers, Vendors and their business associates. For guidelines on what qualifies as a HIPAA-covered entity, please visit http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/index.html.
ICD-10 compliance means that HIPAA-covered entities must utilize ICD-10 codes for healthcare services delivered on or after Oct 1, 2015. Beginning October 1, 2015, Ameritox will be unable submit claims using requisitions containing ICD-9 codes. Ameritox will contact the customer submitting such a requisition in an effort to obtain an ICD-10 code, which may delay filing of these claims.
Diagnosis coding under the ICD-10-CM (Clinical Modification) system uses 3-7 alpha and numeric digits and full code titles, but the format is very much the same as ICD-9-CM.
Diagnosis coding under the ICD-10-PCS (Procedure Coding System) uses 7 alpha or numeric digits while the ICD-9-CM coding system uses 3 or 4 numeric digits.
The new classification system provides significant improvements through greater detailed information and the ability to expand to capture additional advancements in clinical medicine.
The ICD-10-CM and ICD-10-PCS code sets, as well as the official ICD-10-CM guidelines, are available free of charge on the:
Additionally, we recommend that customers contact their payers and trading partners in advance of the October 1 deadline to request a copy of the crosswalk mapping tool these entities are utilizing.
CMS offers free help, including tools to jumpstart your efforts. A good place to start is with the new ICD-10 Quick Start Guide at: http://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10QuickStartGuide20150622.pdf
Ameritox will update its online and paper requisitions to enable the selection of ICD-10 codes that are commonly used to support medical necessity in urine drug monitoring. As a reminder, it is the physician’s responsibility to use his or her professional medical judgment to indicate the most appropriate diagnosis code(s) for each patient encounter. A comprehensive listing of commonly used ICD-10 codes in UDM may also be found at www.ameritox.com/codes and www.ingenuityhealth.com/codes.