ICD-10 Resources

ICD-10 Compliance Date Announced!

On July 31, 2014, the U.S. Department of Health and Human Services (HHS) issued a rule (CMS-0043-F) finalizing October 1, 2015, as the new compliance date for health care providers and health plans to transition to ICD-10. ICD-10 represents a significant code set change that impacts the entire health care community.

By using ICD-10, doctors can capture much more information, meaning they can better understand important details about the patient’s health than with ICD-9-CM. ICD-10 reflects improved diagnosis of chronic illness and identifies underlying causes, complications of disease, and conditions that contribute to the complexity of a disease. Additionally, ICD-10 captures the severity and stage of diseases such as chronic kidney disease, diabetes and asthma.

By enabling more detailed patient history coding, ICD-10 can help to better coordinate a patient’s care across providers and over time. ICD-10 improves quality measurement and reporting, facilitates the detection and prevention of fraud, waste and abuse, and leads to greater accuracy of reimbursement for medical services.

The previous revision, ICD-9-CM, contains outdated, obsolete terms that are inconsistent with current medical practice, new technology and preventive services.

ICD-10 Tips

  • ICD-9 codes will no longer be accepted on claims with dates of service (DOS) or discharge after September 30, 2105.
  • ICD-10 codes will not be accepted on claims with DOS or discharge before October 1, 2015.
  • Both ICD-9 and ICD-10 codes cannot be reported on the same claim.
  • ICD-10-CM (diagnoses) will be used in all settings.
  • ICD-10-PCS (procedures) will be used for inpatient procedures only.

CMS has created "Road to 10" to help Providers jump-start the transition to ICD-10. Visit http://www.roadto10.org to learn more.

Resource Materials

Frequently Asked QuestionsPDF File Indicator Image

Tips for ImplementationPDF File Indicator Image

External Links

AHIMA's ICD-10-CM/PCS Documentation Tips

Centers for Medicare and Medicaid Services (CMS)

Department of Health Care Services - Medi-Cal (DHCS)

National Center for Health Statistics

Questions?

If you have questions about ICD-10 or would like more information, email us at ICD10Questions@caloptima.org

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