Five Facts about ICD-10 from CMS

by Phil C. Solomon on April 24, 2015

in ICD-10

icd-10There are so many uncertainties surrounding the ICD-10 transition, it’s helpful when CMS offers information and feedback to help providers understand what they are getting into. If you haven’t seen this yet, I hope it helps to clarify the facts. You’ll find more information at – PCS


Five Facts about ICD-10

To help dispel some of the myths surrounding ICD-10, the Centers for Medicare & Medicaid Services (CMS) recently talked with providers to identify common misperceptions about the transition to ICD-10. These five facts address some of the common questions and concerns CMS has heard about ICD-10:

1. The ICD-10 transition date is October 1, 2015.
The government, payers, and large providers alike have made a substantial investment in ICD-10. This cost will rise if the transition is delayed, and further ICD-10 delays will lead to an unnecessary rise in health care costs. Get ready now for ICD-10.

2. You don’t have to use 68,000 codes.
Your practice does not use all 13,000 diagnosis codes available in ICD-9. Nor will it be required to use the 68,000 codes that ICD-10 offers. As you do now, your practice will use a very small subset of the codes.

3. You will use a similar process to look up ICD-10 codes that you use with ICD-9. Increasing the number of diagnosis codes does not necessarily make ICD-10 harder to use. As with ICD-9, an alphabetic index and electronic tools are available to help you with code selection.

4. Outpatient and office procedure codes aren’t changing.
The transition to ICD-10 for diagnosis coding and inpatient procedure coding does not affect the use of CPT for outpatient and office coding. Your practice will continue to use CPT.

5. All Medicare fee-for-service providers have the opportunity to conduct testing with CMS before the ICD-10 transition.

Your practice or clearinghouse can conduct acknowledgement testing at any time with your Medicare Administrative Contractor (MAC). Testing will ensure you can submit claims with ICD-10 codes. During a special “acknowledgement testing” week to be held in June 2015, you will have access to real-time help desk support. Contact your MAC for details about testing plans and opportunities.

Keep Up to Date on ICD-10 – Visit the CMS ICD-10 website for the latest news and resources to help you prepare.


Phil C. Solomon is the publisher of Revenue Cycle News, a healthcare business information blog. He serves as the Vice President of Global Services for MiraMed, a worldwide healthcare BPO company. MiraMed provides solutions to leading hospitals, health systems, large physician groups and industry partners providing services in the areas of revenue cycle optimization, medical coding, clinical improvement documentation and technology integrations.Phil has 25 years of experience as an industry thought leader, strategist, solution provider, author and featured speaker. He has worked closely with some of the industry’s best and brightest leaders in healthcare finance and revenue cycle operations.

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