ICD-10

Overview

The International Classification of Disease tenth revision (ICD-10) is a system of coding created by the World Health Organization that notes various medical records including diseases, symptoms, abnormal findings and external causes of injury.

The ICD-10 was created in 1992 as the successor to the previous ICD-9 system. In the United States, an official use of the ICD-10 system will begin on October 1st, 2013. It will be split into two systems: ICD-CM: (clinical modification) for diagnostic coding and ICD-10-PCS (procedure coding system) for inpatient hospital procedure coding.

ICD-10 CM

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) is a revision to the ICD-9-CM system used by physicians and other health care providers to classify and code all diagnoses, symptoms and procedures recorded in conjunction with hospital care in the United States.

Like ICD-9-CM, the ICD-10-CM is based upon the International Classification of Diseases, which is published by the World Health Organization (WHO) and which uses unique alphanumeric codes to identify known diseases and other health problems. According to WHO, the ICD assists in the storage and retrieval of diagnostic information and in the compilation of national mortality and morbidity statistics.

The ICD-10-CM revision includes more than 68,000 diagnostic codes, compared to 13,000 in ICD-9-CM. In addition, ICD-10-CM includes twice as many categories and introduces alphanumeric category classifications for the first time.

ICD-10 PCS

The International Classification of Disease tenth revision Procedure Coding System (ICD-10-PCS) is a system of medical classification used for procedural codes that track various health interventions taken by medical professionals.

The PCS was published by the World Health Organization to track international morbidity and mortality statistics in a comparable way. The system uses three to seven digit alphanumeric codes to specify medical procedures. The first digit indicates the section of medical practice (surgery, administration, measuring and monitoring, etc.) and the following digits specify the body system, root operation, body part, approach and the device used. The seventh character is a qualifying digit. The crucial first three digits of a code are stored in the ICD manual for reference. For example, a code beginning in 0C0 would be a medical/surgical procedure on the mouth or throat – specifically, an alteration.

The ICD-10 replaced the ninth revision of the system in 1993 and the ICD-10-PCS is a clinical modification of the original ICD-10. ICD-10-PCS codes must be used on all HIPAA transactions, starting in October 2013.

On January 16, 2009, the Department of Health and Human Services published the final regulation (45 CFR 162.1002) that adopted the ICD-10-CM and ICD-10-PCS code sets as HIPAA standards. This rule required the se of the ICD-10 code sets in all HIPAA transactions. The compliance date published in the final rule is October 1, 2013. Since ICD-10 code sets are medical code sets, the compliance date indicates the date of service for which these codes must be used. Therefore the ICD-10 code sets must be used in the transactions when the service date in the transaction is on or after October 1, 2013.

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