ICD-9-CM vs. ICD-10-CM

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Transcript ICD-9-CM vs. ICD-10-CM

ICD-10 Providers Information
 Expanded diagnosis and surgical procedure code sets to be much
more specific
 Expanded field format for ICD-10 codes
 From 3-5 to 3-7
 Compliance of HIPAA mandate to have bills paid effective 10/1/14
 Bills with dates of service on or after 10/1/14 must use ICD-10 codes to
be paid
 Bills with dates of service prior to 10/1/14 must continue to use ICD-9
codes to have bills paid
 IP Bills with a discharge date on or after 10/1/14 must use ICD-10 codes
to be paid
 IP Bills with a discharge date prior to 10/1/14 must continue to use
ICD-9 codes to be paid
 Bills cannot contain both ICD-9 and ICD-10 codes on the same bill
ICD-10 Announcements
 The Office of Workers’ Compensation Programs (OWCP) will adopt the use
of the International Classification of Diseases, 10th Edition diagnosis and
procedure codes (ICD-10) on a schedule aligned with the Centers for
Medicare & Medicaid Services (CMS)
 For services provided on or after October 1, 2014, OWCP will require all
providers to only use the ICD-10 code sets
 For services provided prior to October 1, 2014, only ICD-9 codes will be
 We will be following CMS guidance for implementing ICD-10 on October 1,
2014. Please visit the CMS ICD-10 website for additional information,
resources and the latest news on the ICD- 10 transition,
Web Homepage
1500 Claim Form Changes
The National Uniform Claim Committee (NUCC) has approved a transition
timeline for the version 02/12 1500 Health Insurance Claim Form (1500 Claim
Form). In June, the NUCC announced the approval of the updated 1500
Claim Form that accommodates reporting needs for ICD-10 and aligns with
requirements in the Accredited Standards Committee X12 (ASC X12) Health
Care Claim: Professional (837P) Version 5010 Technical Report Type
 Effective March 1, 2014: Payers receive and process paper claims
submitted only on the revised 1500 Claim Form (version 02/12)
 ICD-10 codes will be rejected as an invalid code until October 1, 2014
How to Submit a 1500
 Instructions on completing the new 1500 can be
found at the following website under forms and links
 http://owcp.dol.acs-inc.com/portal/main.do