ICD-10 Readiness

ICD-9 versus ICD-10

ICD-10 represents the 10th revision of the International Classification of Diseases (ICD) adopted by the World Health Organization (WHO) in 1994. It is used to categorize diseases and many other types of related issues that are documented on health records and death certificates.

The WHO has authorized the development of the ICD-10-CM (clinical modifications) as well as the ICD-PCS (procedural coding system) for use in the United States. The ICD-10-CM code sets lists diagnosis codes while the ICD-10-PCS contains procedure codes for inpatient reporting for hospitals.

ICD-10 contains a multitude of new diagnosis and procedure codes. The EDI version 5010 is a prerequisite of ICD-10 and has been mandated since January 1, 2012 with a government transaction enforcement date of June 30, 2012. All inpatient claim discharge dates and outpatient service dates that occur on or after October 1, 2015 must use ICD-10 codes. Failure to use these new codes may result in transactions being rejected and delays in reimbursements.

Our Compliance Plan

HealthSmart recognizes that transitioning from ICD-9 to ICD-10 will require a multidisciplinary approach within the organization in order to successfully implement the new code sets. As such, HealthSmart has assembled an ICD-10 Steering Committee to identify and analyze the effects of the changes and necessary modifications. The ICD-10 Steering Committee is comprised of representatives from all areas of the organization and each individual is tasked with implementing appropriate action plans within their respective business unit.
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