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ICD-10
ICD-10 information

Basic introduction to ICD-10

The final rule was published January 16, 2009

October 1, 2013- Compliance date for implementation of ICD-10

  • Single implementation date for all users.
  • Date of service for ambulatory and physician reporting
  • Date of discharge for inpatient settings
  • ICD-9-CM codes will not be accepted for services provided on or after October 1, 2013
  • ICD-9-CM claims for services prior to implementation date will continue to flow through systems for a period of time.
  • No grace period

About the Version 5010 Transition on January 1, 2012
On January 16, 2009, the Department of Health and Human Services (HHS) announced that updated versions of the HIPAA transactions will be required for use by physicians and others on January 1, 2012. The Centers for Medicare and Medicaid Services (CMS), is the agency within HHS charged with overseeing compliance with the standards.

The first ICD-10-related compliance date is less than 2 years away.
On January 1, 2012, standards for electronic health care transactions change from Version 4010/4010A1 to Version 5010. These electronic health care transactions include functions like claims, eligibility inquiries, and remittance advices.  Unlike the current Version 4010/4010A1, Version 5010 accommodates the ICD-10 codes, and must be in place first before the changeover to ICD-10. The Version 5010 change occurs well before the ICD-10 implementation date to allow adequate Version 5010 testing and implementation time.

If providers do not conduct electronic health transactions using Version 5010 as of January 1, 2012, delays in claim reimbursement may result. If health plans cannot accept Version 5010 transactions from providers, they may experience a large increase in provider customer service inquiries affecting their operations.  System changes are required to accommodate the ICD-10 codes. 

Preparing for ICD-10 and Version 5010 – including potential updated software installation, staff training, changes to business operations and workflows, internal and external testing, reprinting of manuals and other materials, and more – will take time.

Calendar I list of events

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