ICD 10 Transition FAQ

Get the basic facts on the transition to ICD 10 codes and how HCC Coders can help with this process

Coding staffStarting on October 1, 2014, all physicians, hospitals, and health plan providers will be required to begin using ICD 10 codes instead of ICD 9 codes to track patient services, predict future needs, and secure reimbursements from programs like Medicare Advantage. The transition will be complex, and most organizations have been preparing for many months already. If you are new to this field or work for a small medical practice that’s running behind schedule on implementation planning, you may have some questions. Here are some answers to commonly asked questions about ICD 10 to help you out.

What is ICD 10?

ICD 10 is a set of medical diagnosis and service codes developed by the World Health Organization. This set represents the 10th revision of the International Statistical Classification of Diseases protocol.

Why are we transitioning to ICD 10?

There are several reasons America is now transitioning to ICD 10. First of all, ICD 10 contains five times as many codes as our current ICD 9 code set, allowing more specific medical data to be recorded about each patient. This helps patients receive better care and also helps analysts predict the future burden of programs like Medicare more accurately. Another important reason why we’re making the transition is that ICD 10 includes codes reflecting many recent advancements in medical science, and also offers room to grow in the future when we may need to add more codes. Finally, transitioning to ICD 10 will enable doctors to compare medical data across international borders more easily.

I don’t deal with Medicare—do I have to transition?

Yes. Any provider dealing with a patient covered by HIPAA must transition to ICD 10 for all diagnoses and hospital inpatient services.

Why are there so many weird codes?

Many recent news stories have made light of the fact that the ICD 10 code set contains codes for things like “crushed by a crocodile” and “drowning after jumping off burning water skis.” These codes do seem a little strange, but remember that the goal of the ICD code set is to help provide greater precision in coding and hence also in care. These codes exist because these situations have happened and may happen again!

What happens if I don’t make the transition on time?

If you submit a claim using ICD 9 codes after the transition date has passed, your claim will not be processed and you will not receive your reimbursement.

Can I transition early?

No. Claims using ICD 10 will not be accepted or processed until the transition date. However, you should begin preparing for the transition now by implementing plans to upgrade your software, alter workflows as needed, and ensure coordination with other parties.

How can I make sure my staff is trained?

The government is offering training resources, and private companies are also putting together training programs. When it comes to training your coding staff, however, you can actually skip this step by hiring your coders directly from HCC Coders. We will make sure your coding staff is already fully trained in the new coding protocols and able to begin assisting you immediately upon the transition date.