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    ICD-10 Information

    ICD-10 Survey

    The first ICD-10 Provider Readiness Survey is now available. This survey will be available for completion from Friday, April 12, 2013 through close of business on Monday, May 20, 2013.
     
    The survey’s objective is to determine the impact of ICD-10 to your practice and where you are in your transition planning and implementation. Information you provide will help identify issues you and other Medicaid providers are having complying with the federal mandate to transition to ICD-10.
     
    It will take approximately 10 minutes to complete this survey.
    Who Should Complete the Survey? 
    The individual in your organization who is responsible for planning, implementing, and/or managing the transition from using the ICD-9 codes to the ICD-10 codes should complete the survey. 
     
    Thank you for your participation.

    The Deadline for the Transition to ICD-10 is October 1, 2014

    On August 27, 2012, Health and Human Services announced the release of the rule finalizing a one-year proposed delay for the industry’s transition to ICD-10 codes. The date has been delayed from October 1, 2013 to October 1, 2014.

    The ICD-10 implementation date of October 1, 2014 was filed on August 24, 2012 within the Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier; Addition to the National Provider Identifier Requirements; and a Change to the Compliance Date for the International Classification of Diseases, 10th Edition (ICD-10-CM and ICD-10-PCS) Medical Code Data Sets, Final Rule. The Final Rule can be viewed in the Federal Register published on September 5, 2012.

    The Department of Public Welfare acknowledges the new ICD-10 compliance date and has adjusted our schedule to align with the October 1, 2014 implementation date.

    CMS 1500 Form Revision Update:
     
    On March 27, 2012, the National Uniform Claim Committee (NUCC) announced the release of a revised version of the 1500 Health Insurance Claim Form (version 02/12). This revised version will update the current 1500 Claim Form (version 08/05).
     
    The CMS-1500 form revision includes changes to accommodate ICD-10 code changes, but does not rely on the implementation of ICD-10 to become active. More information is available from the NUCC website at nucc.org.
     
    The 02/12 revised 1500 Claim Form remains under approval by the Centers for Medicare & Medicaid Services (CMS). A 30-day comment period by the Office of Management and Budget (OMB) closed on October 22, 2012. CMS is currently awaiting approval of the form by OMB.
     
    Although no major changes are anticipated, it is possible that changes could be made as part of the approval process. Once the 02/12 revised 1500 Claim Form has been officially approved by CMS and OMB, the final version will be released. An approval timeframe is not known at this time.

    Background

    On January 16, 2009, HHS published a final rule to adopt ICD-10 as the HIPAA standard code sets to replace the previously adopted ICD–9–codes for diagnosis and procedure codes in the HIPAA Administrative Simplification; Modifications to Medical Data Code Set Standards to Adopt ICD-10-CM and ICD-10-PCS, 74 FR 3328. The compliance date set by the final rule was October 1, 2013.
     
    Implementation of ICD-10 will accommodate new procedures and diagnoses unaccounted for in the ICD-9 code set and allow for greater specificity of diagnosis-related groups and preventive services. This transition will allow for improved accuracy in reimbursement, fraud detection, historical claims and diagnoses analysis for the health care system. Much research has been conducted and findings have been published regarding the positive effects of ICD-10 on quality issues.
     
    To ensure a smooth conversion, all covered entities must transition to ICD-10 at the same time. Failure of any one industry segment to achieve compliance with ICD-10 would negatively impact all other industry segments and result in rejected claims and provider payment delays.

    Resources

    General ICD-10 Information
    Fact Sheets
    Federal Register

    Contact Us

    For questions and/or to provide feedback about the ICD-10 implementation, please contact us at:
     
    Email: RA-pwomapicd10@pa.gov
     
    To join our ICD-10 Listserv click here

     

    Topics Related to ICD-10 Information