October 1, 2015 marks the official compliance date for implementation of the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10) by Centers for Medicare and Medicaid Services (CMS), the first update to the standardized codes for medical conditions and procedures in over 35 years. The newly expanded codes — jumping from 14,000 to 69,000 — will grant healthcare professionals greater specificity and clinical accuracy for noting procedures and diagnoses, but could also present obstacles and headaches in the transition from the previous ICD-9 codes.
What’s Changed With ICD-10?
After delaying the implementation deadline several times, the new ICD-10 code set will allow for greater measurement of patient outcomes and care, along with improved clinical decisions for healthcare providers. Besides the expansion in the number of codes for procedures and diagnoses, some of the most significant changes are noted below:
Medicare claims processing systems will not accept ICD-9 codes for dates of services after September 30, 2015 and will not accept claims that include both ICD-9 and ICD-10 codes. However, CMS and the American Medical Association (AMA) agreed to a one-year grace period in which Medicare claims will not be denied based on which diagnosis code was selected, as long as an ICD-10 code from an appropriate family of codes is submitted; the family of codes is considered the same as the ICD-10 three-character category. For example, if a patient has a diagnosis of G43.711 (Chronic migraine without aura, intractable, with status migrainosus) under ICD-10, use of the valid codes G43.701 (Chronic migraine without aura) or G43.719 (Chronic migraine without aura, intractable without status migrainosus) would likely not prompt an audit during the 12-month grace period.
This article originally appeared on MPR