ICD-10: What You Need To Know

July 16, 2015

Are you ready for ICD-10 blur (3)

What is ICD-10?

International Classification of Disease (ICD)-10, according to the World Health Organization (WHO), is “the international standard diagnostic classification for all general epidemiological, many health management purposes and clinical use.” ICD-10 is an updated edition of ICD codes that will replace the current ICD-9 codes being used in the United States.  ICD-10 will have additional codes that are more accurate and more detailed then the ICD-9 codes. ICD-10 will begin being used  on October 1, 2015.  It contains two types of codes ICD-10-CM and ICD-10-PCS.  The ICD-10-CM codes are diagnosing codes and ICD-10-PCS codes are inpatient procedure codes


ICD-9 vs ICD-10

ICD-10 infographic


Why make the change?

Although this major update will take an extensive amount of training, ICD-10 offers many benefits that ICD-9 did not.  ICD-9 is over 30 years old and contains codes that are outdated and in some cases inconsistent with current medical practices.  ICD-10 offers nearly 123,000 additional and more detailed code sets that were not offered by ICD-9.  Access to a larger and more detailed database of codes will allow for more accurate epidemiological tracking.   This is because ICD-10 codes help identify disease etiology, anatomic site and severity, details that were not identified by ICD-9.   The implementations of the ICD-10 code will also improve the quality of data tracking to measure the quality and safety of care and process claims for reimbursement.   ICD-10 will enhance clinical, financial, and administrative performance.

Currently the United States is the only country using ICD-9, other countries have already made the switch, making it difficult to compare data from country to country.  Making the switch to ICD-10 will solve this problem and make it possible for the United States to compare health data with other countries.

It is also important to make the switch because ICD-10 coding will be mandatory.  According to Humana.com, “An entity covered by the Health Insurance Portability and Accountability Act (HIPAA) must be able to successfully conduct health care transactions using ICD-10 diagnosis and procedure codes. ICD-9 diagnosis and procedure codes can no longer be used for services provided on or after the Centers for Medicare & Medicaid Services (CMS) implementation date of Oct. 1, 2015.”   Any claims that do not contain ICD-10 diagnosis will not be processed.

The switch from ICD-9 to ICD-10 is an important change that will benefit the medical world in numerous ways.  Are you ready for October 1st?