Practice Management & Allied Staff
News & Materials
ICD-10 Code Sets and Electronic Transaction Standards
March 9th, 2009
The Department of Health and Human Services (HHS) recently announced a final regulation effective October 1, 2013, that would replace the ICD-9-CM code sets now used to report health care diagnoses and procedures with greatly expanded ICD-10 code sets. In a separate final regulation, HHS has final adopting the updated X12 standard, Version 5010, and the National Council for Prescription Drug Programs standard, Version D.0, for electronic transactions, such as health care claims. Version 5010 is essential to use of the ICD-10 codes.
Developed almost 30 years ago, ICD-9 is now widely viewed as outdated because of its limited ability to accommodate new procedures and diagnoses. ICD-9 contains only 17,000 codes and is expected to start running out of available codes next year. By contrast, the ICD-10 code sets contain more than 155,000 codes and accommodate a host of new diagnoses and procedures. The additional codes will help to enable the implementation of electronic health records because they will provide more detail in the electronic transactions.
Please note that AAOMS will continue to monitor the progression of these two rules and report new information as it becomes available. For more information, please visit, www.cms.hhs.gov/TransactionCodeSetsStands. Fact sheets describing both final rules will be available at http://www.cms.hhs.gov/apps/media/fact_sheets.asp.