CMS Publishes ICD-10 Transition Guide for Health Care Providers

On Friday, CMS issued a seven-page guide to help health care providers transition to new ICD-10 code sets, Modern Healthcare reports (Conn, Modern Healthcare, 9/16).

Background

For about 30 years, health care providers have used ICD-9 code sets for electronic health transactions. However, ICD-9 code sets no longer can be expanded effectively to include codes for new diseases and procedures.

Health care providers have until Oct. 1, 2013, to adopt new ICD-10 code sets. The switch from ICD-9 to ICD-10 code sets means that health care providers and insurers will have to change out nearly 15,000 codes for about 68,000 codes (iHealthBeat, 9/14).

About the Guide

CMS' guide targets health care providers and suppliers who submit claims to Medicare. According to the guide, all HIPAA-covered entities will need to use the ICD-10 code sets in standard transactions.

The guide provides information on:

  • How to handle claims for services that span the transition dates between when ICD-9 and ICD-10 codes are applicable; and
  • Rules requiring health care providers to submit the most specific diagnostic codes possible based on available information (CMIO, 9/16).

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