What is ICD-10?
Right now, the U.S. health care system relies on a set of codes, referred to as ICD-9, to report diagnoses and in-patient procedures. Introduced in the late 1970s, the ICD-9 code set will soon be replaced by the more detailed ICD-10, with a deadline for the transition of October 1, 2015.
What is ICD-10? It's helpful first to know what ICD is. ICD stands for the International Classification of Diseases, and its codes hold critical information about epidemiology, managing health, and treating conditions.
Health care professionals use ICD codes to record and identify health conditions. Public health workers can use the recording of ICD codes to see trends in health, and track morbidity and mortality. And insurers use ICD codes to classify conditions and determine reimbursement.
The transition from ICD-9 to ICD-10 is huge, as it reflects a five-fold increase in diagnosis codes, to roughly 69,000 codes. Transitioning to ICD-10 is required by anyone covered by the Health Insurance Portability Accountability Act (HIPAA)—this includes doctors, hospitals and health insurance companies, all of whom rely on these codes for diagnosing patients and billing for services.
If a medical practice or insurance payer doesn't switch to ICD-10 by the deadline, claims cannot be processed. Keep in mind, the transition does not affect or change the American Medical Association's CPT (Current Procedural Terminology) codes used for outpatient procedures.