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Overview of ICD-10 | Key Differences of ICD-10 | Frequently Asked Questions | Web Resources

Overview of ICD-10-CM/PCS

On January 16, 2009, the U.S. Department of Health & Human Services (HHS) published the final rule mandating the adoption the (1) International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for diagnosis classification and coding and (2) the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) for inpatient procedure coding, effective October 1, 2014. The use of ICD-10-CM and ICD-10-PCS applies to all "Covered Entities," that is health plans, health care clearinghouses and health care providers that transmit electronic health information in connection with the Health Insurance Portability and Accountability Act (HIPAA) transaction standards. These mandated standards are a revision to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) Volumes 1 and 2, and the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) Volume 3 used by physicians and other health care providers to classify and code all diagnoses and procedures, respectively, in the United States. Current Procedural Terminology (CPT) codes remain the platform for outpatient procedure coding.

The Commission will conform to the U.S. Department of Health & Human Services (HHS) mandate and require Maryland hospitals to submit inpatient and outpatient discharge data using the ICD-10-CM/PCS coding. The transition will require business and system changes throughout the healthcare industry. Stages of the ICD-10-CM/PCS implementation could include the following: assessment, strategy development, installation, training, testing with payers and vendors, and risk management. It is important that you begin planning now to make this transition to ICD-10 from ICD-9.

Tentatively beginning in October 2013, hospitals will have an opportunity to submit ICD-10 test data to the HSCRC.

Overview of ICD-10 | Key Differences of ICD-10 | Frequently Asked Questions | Web Resources