ICD-10 deadline

[cshelton1956@comcast.net]

When the ICD-10 deadline hits, will we be able to use any ICD-9 codes at all? Or will everyone use ONLY ICD-10 codes????

[mitchellde]

ICD-10 CM usage is based on visit date. once the date of activation is here lets say it is OCT 1 2013, then for all visit date prior to OCt 1 2013 you use ICD-9 CM codes and for visits date Oct 1 2013 and forward you use ICD-10 CM codes. The 5010 transaction has a one digit version indicator that will be placed on the claim to indicate whether it is an ICD-9 CM claim or an ICD-10 CM claim. After the implementation of ICD-10 CM, ICD-9 CM will no longer be updated in anyway, only ICD-10 CM will be revised and updated regularly.

[mmorningstarcpc]

Nice answer, Debra!

I have one additon to add.....

When ICD-10 becomes effective, ICD-9 may still be used by worker's compensation and possibly by some auto insurance carriers. WC and auto currently use CPT codes (and I would imagine ICD-9) that are several years old.

I think this creates problems for those billing WC or auto, but unfortunately, if you accept them, you have to bill them at their direction.

[cshelton1956@comcast.net]

Thank you both so much for your answers. That really makes sense to me now.

[Chicoine]

CMS will only accept ICD 10 codes on claims for services provided on or after October 1, 2014. This means that if your provider rendered services before October 1 but submits the claim after October 1, the claims must be coded using ICD 9. Essentially, you will need a dual coding system for about 3 - 6 months until those claims for services rendered before October 1 get paid.

This raises the question of what happens if patient is admitted to hospital on Sept 15th and discharged on October 15th - mixed codes, one or the other? I don't know.....

[mitchellde]

It is based on visit/admit date, if the patient is admitted prior to Sept 15 then the hospital will use ICD-9 codes when they code the discharge. The provider will use the appropriate codes based on the date they see the patient, so the visits before OCt 1 they will use ICD-9 and the visits after oct 1 they will use ICD-10 CM.

[lorrpb]

>>It is based on visit/admit date, if the patient is admitted prior to Sept 15 then the hospital will use ICD-9 codes when they code the discharge<<

I respectfully disagree.

For the period around October 1, 2013, the usual coding rule for inpatient services will apply: the code in use on the date of discharge not the date of admission will be the one employed; therefore, if a patient is discharged on or after October 1, 2013, ICD-10 must be used.
http://news.aapc.com/index.php/2009/...013-announced/

Of course, 2013 will likely become 2014 if the proposed rule is adopted, but unless they change anything else inpatients will be coded based on date of discharge.

Lorraine Papazian-Boyce, MS, CPC
AHIMA-Approved ICD-10-CM/PCS Trainer