Health Information Management

Q/A: Remember these dates for smooth transition to ICD-10

APCs Insider, July 29, 2011

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Q: What’s the newest timeline for the transition to ICD-10-CM? We know the important role diagnosis code(s) play in the APC system with respect to local coverage determinations and associated CPT® codes and we want to be prepared.

A: The plan is for the last full updates to ICD-9-CM to occur October 1, 2011. A partial freeze will be initiated for 2012 and 2013, with regular updates to ICD-10-CM resuming in 2014. Note the following schedule:

  • October 1, 2011—ICD-9-CM and ICD-10 code sets will undergo regular annual updates.:
  • October 1, 2012— ICD-9-CM and ICD-10 code sets will undergo limited code updates to capture new technologies and diseases.
  • October 1, 2013—ICD-10 code sets only will undergo limited code updates to capture new technologies and diseases. ICD-9-CM will no longer be in use for reporting and will not undergo any updates.
  • October 1, 2014—Regular ICD-10 updates resume. 

The limited updates in 2012 and 2013 are required by §503(a) of the Medicare Prescription Drug Improvement and Modernization Act of 2003.

Facilities must report ICD-10-CM for hospital outpatient services, ambulatory services, physician professional services, and for inpatient discharges on or after October 1, 2013.

ICD-9-CM codes will not be accepted for services provided on or after October 1, 2013, although claims for services provided before October 1, 2013, will be processed for payment for a period of time.

Editor’s note: Andrea Clark, RHIA, CCS, CPCH, president of Health Revenue Assurance Associates, Inc., in Plantation, FL, answered this question.



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