International Classification of Diseases - 10th Edition (ICD-10)
Starting October 1, 2014, the health care industry’s payers, providers, vendors, and all Health Insurance Portability and Accountability Act (HIPAA) covered entities will be required to use ICD-10 diagnosis (CM) and inpatient procedure code sets (PCS). The 10th edition of these code sets replaces the ICD-9 code sets that have been in use in the United States since 1979.
The key differences between ICD-9 and ICD-10 include the following:
The Department’s ICD-10 Project Team recently surveyed the Medicaid provider community to assess general readiness for the ICD-10 transition on 10/1/2014. The surveyed closed on December 31, 2013. Click here to review the survey results. Note: additional ICD-10 resources are posted below.
SMA ICD-10 Provider Readiness Assessment Closed February 10, 2014
Thank you for participating in the SMA ICD-10 Provider Readiness Assessment. The national results have been tabulated and are currently under review at CMS. Once reviewed, the National results will be reported and made available. Following the individual State and territory results, data will be made available. The national and individual data summaries for Colorado should be available mid-March. The result location will be posted soon.
There is a wealth of ICD-10 resources available to prepare for the transition from ICD-9. Please visit the following websites for more information:
Regulatory reference including Implementation Guides and Checklists
|Centers for Medicare and Medicaid Services (CMS)|
|ICD-10 Free Coding Reference|
ICD-10 Health Care News
Additional Coding Initiatives
National Correct Coding Initiative (NCCI)
This cost-savings initiative was implemented April 1, 2013. It helps the health care industry financially by reducing or preventing errant payments related to improper coding. NCCI applies only to procedure codes (inpatient or outpatient) with the caveat that it applies to inpatient procedure codes that are not used in APR-DRG. Please visit the Department’s NCCI website for more information.
All Patient Refined-Diagnosis Related Group (APR-DRG)
This initiative involves an expansion of the basic DRG structure, includes severity of illness and risk of mortality factors, and is intended for all patient populations. The Department has begun the work effort to transition from the CMS-DRG to the APR-DRG system. APR-DRG will be implemented based on ICD-9 diagnosis and procedure codes and will be ready to accommodate new ICD-10 codes. Please visit the Department’s APR-DRG website for more information.
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