The International Classification of Diseases (ICD) is the international standard diagnostic classification for all clinical use. The International Classification of Diseases, Tenth Revision (ICD-10) was endorsed by the Forty-third World Health Assembly in 1990 and came into use in World Health Organization (WHO) member states in 1994. Only a handful of countries, including the United States, have not adopted ICD-10 as their standard for reporting. The department of Health and Human Services (HHS) has mandated the replacement of the ICD-9-CM code sets that medical coders and billers in the United States use now to report health care diagnoses and procedures with ICD-10 code sets, effective Oct. 1, 2013. The X12 Version 5010 (Version 5010) transaction code set is a prerequisite for the implementation of ICD-10.
The move to ICD-10 is a critical step for the healthcare industry in facilitating electronic data exchange due to the limitations of ICD-9.
Current limitations of ICD-9 include:
- Limited capability to accommodate new procedures, diagnoses and services such as preventive services
- Limited code specificity
- Inability to support emerging industry needs such as pay-for-performance and bio-surveillance
- Inconsistent use of terminology
- Inability to capture new technology
Anticipated benefits from adoption of the ICD-10 code sets include:
- More accurately defined patient services
- More specific diagnosis and treatment information
- More comprehensive reporting of quality data
- More accurate payments for new procedures with fewer rejected claims
Additional sources for information on ICD-10
CMS
http://www3.cms.gov/ICD10/
AMA
http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/transaction-code-set-standards/icd10-code-set.shtml
MGMA
http://www.mgma.com/policy/default.aspx?id=33751
HIMSS
http://www.himss.org/ASP/topics_FocusDynamic.asp?faid=220
WHO
http://www.who.int/classifications/icd/en/index.html
Reminder for Customers: The ICD-10 & 5010 Readiness pages of the client portal, Support Center is updated regularly with additional information, resources, and readiness plans for your practice management solution.
