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ICD-10 Information

Announcements and Upcoming Events

Upcoming Events

None at this time.

Announcements

From the link: This final rule implements section 212 of the Protecting Access to Medicare Act of 2014 by changing the compliance date for the international Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) for diagnosis coding, including the Official ICD-10-CM Guidelines for Coding and Reporting, and the International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) for inpatient hospital procedure coding, including the Official ICD-10-PCS Guidelines for Coding and Reporting, from October 1, 2014 to October 1, 2015. It also requires the continued use of the International Classification of Diseases, 9th Revision, Clinical Modification, Volumes 1 and 2 (diagnoses), and 3 (procedures) (ICD-9-CM), including the Official ICD-9-CM Guidelines for Coding and Reporting, through September 30, 2015.

Introduction

Are You Ready for ICD-10 Diagnosis Coding?

Have you ever seen someone who was struck by a turtle? With the new ICD-10 codes you will have a code specifically for being stuck by a turtle:

W59.22XA
Contact with turtles, struck by turtle, initial encounter

If you had provided services to someone who was struck by a turtle, under ICD-9 diagnosis coding, you would have billed:

E906.8
Other specified injury caused by animal

ICD-10 is much more detailed than the ICD-9 codes that are currently in use.

There is a lot of information available regarding ICD-10, and this webpage will be a great source of information to help you keep up on the conversion to ICD-10 for Montana Medicaid. Additional links are in the ICD-10 Informational Links panel below.

Encourage your health care professionals to begin documenting their services in more detail now! This will result in a smoother transition for the provider when ICD-10 is implemented on October 1, 2015.

Effective October 1, 2015, all providers will be required under HIPAA to use and bill ICD-10 format codes. For dates of service on or after October 1, 2015, claims submitted with an ICD-9 code will be denied.

This is based on the date of service billed, not the date of claim submission. When billing, providers will need to ensure they use ICD-9 codes for services provided on and before September 30, 2015, and ICD-10 codes for services on and after October 1, 2015.

ICD-10 Comparison
Item ICD-9-CM ICD-10-CM
Code Length 3–5 characters 3–7 characters
Number of Codes Approximately 14,000 codes Approximately 68,000 codes
Code Makeup Digit 1 = alpha or numeric
Digit 2-5 = numeric
Digit 1 = alpha
Digit 2 = numeric
Digit 3–7 = alpha or numeric
Expandability (space for new codes) Limited Flexible
Code Detail Vague Very specific
Code Examples E917.4
Striking against or struck accidentally by other stationary object without subsequent fall
W22.02XA
Walked into lamppost, initial encounter

Item ICD-9-CM ICD-10-PCS
Code Length 3–4 characters 7 alphanumeric characters; all are required
Number of Codes Approximately 4,000 codes Approximately 72,000 codes
Expandability
(space for new codes)
Limited Flexible
Code Detail Limited detail More detail definitions on anatomy site, approach, device, and other information
Code Examples 741
Low Cervical C-Section
10D00Z1
Obstetrics, Pregnancy, Extraction, Products of Conception, Open Approach, No Device, Low Cervical

ICD-10 Informational Resources

ICD-10 Implementation Success Initiative

To help your ICD-10 implementation efforts, the American Association of Professional Coders (AAPC), the Workgroup for Electronic Data Interchange (WEDI), and the Centers for Medicare and Medicaid Services (CMS) have developed an ICD-10 Implementation Success Initiative.

This initiative is comprised of a searchable public database of ICD-10 issues for submission, help prioritizing those issues, and a series of educational webinars and articles available as a resource to highlight prominent ICD-10 conversion issues and trends.

The searchable database is easy to use. Once you submit your issue, it is reviewed, and once approved, it is made available online. If you provide your name and contact information, WEDI will also follow up with you directly.

Understanding how the new codes and coding standards impact diagnosis and inpatient procedures is imperative to the transition to ICD-10. We encourage you to use this resource for your organization!


Informational Links

Several associations are publishing information on ICD-10 coding. Below are links we believe you will find useful. Even though the implementation date in these resources may not reflect the current date of October 1, 2015, they are still useful resources. The Department of Public Health and Human Services does not promote any one organization/ association over another.

There are also many guides to implementation of ICD-10 coding. The Centers for Medicare and Medicaid Services (CMS) have published information that is helpful to all provider types and payers. 

Additional information about ICD-10 is available on these websites.

If you need help converting ICD-9 and ICD-10 codes, there are free conversion tools to assist you. These tools are only to assist you in code selection, not to directly code for you. Some clinical analysis may be required to choose the most accurate code.

Resources (06/12/2014)

Provider Notices

Training

Contact Information

If you have questions regarding ICD-10 readiness, please contact:

Amber Sark
406.442.6969
asark@mt.gov
Jennifer Tucker
406.442.6969
jtucker2@mt.gov