About ICD-10 

The procedure classification system developed by the Centers for Medicare & Medicaid Services (CMS) for use in the U.S. for inpatient hospital settings only. The new procedure coding system uses 7 alpha or numeric digits.

The compliance date for implementation of ICD-10-CM/PCS is October 1, 2015, for all Health Insurance Portability and Accountability Act (HIPAA)-covered entities. ICD-10-CM, including the “ICD-10-CM Official Guidelines for Coding and Reporting,” will replace ICD-9-CM diagnosis codes in all health care settings for diagnosis reporting with dates of service, or dates of discharge for inpatients, that occur on or after October 1, 2015. ICD-10-PCS, including the “ICD-10-PCS Official Guidelines for Coding and Reporting,” will replace ICD-9-CM procedure codes.

Offical Guidelines can me found at: https://www.cms.gov/Medicare/Coding/ICD10/Downloads/2016-ICD-10-CM-Guidelines.pdf 

The above information was provided by www.cms.gov 


Benefits and Opportunities

The transition to ICD-10-CM/PCS will allow for precise diagnosis and procedure codes, resulting in the improved capture of health care information and more accurate reimbursement. Benefits of ICD-10-CM/PCS include:

  • Improved ability to measure health care services, including quality and safety data
  • Augmented sensitivity when refining grouping and reimbursement methodologies
  • Expanded ability to conduct public health surveillance
  • Decreased need to include supporting documentation with claims
  • Strengthened ability to distinguish advances in medicine and medical technology
  • Enhanced detail on socioeconomic, family relationships, ambulatory care conditions, problems related to lifestyle and the results of screening tests
  • Increased use of administrative data to evaluate medical processes and outcomes, to conduct biosurveillance and to support value-based purchasing initiatives

About HCPCS Coding

The medical coding systems currently used in the United States are ICD-9-CM and HCPCS (Level I CPT codes and Level II National Codes). The Healthcare Common Procedure Coding System (HCPCS) is used to report hospital outpatient procedures and physician services.

These coding systems serve an important function for physician reimbursement, hospital payments, quality review, benchmarking measurement and the collection of general medical statistical data.

For more on AHA Central Office and its role in medical coding and medical coding issues, check out this 2010 article, "Hidden Treasure" by Judy Sturgeon, CSS, in For the Record.

For more information on AHA Central Office, please visit the About Us section of the website.