Implementation of ICD-10 Coding
The Department of Health and Human Services (HHS) published a final rule on January 16, 2009 adopting new code sets to be used by the public and private sectors for reporting diagnoses and inpatient procedures in health care transactions under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Specifically, the rule adopts the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD–10–CM) for diagnosis coding, and the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD–10–PCS) for inpatient hospital procedure coding. These codes replace the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD–9–CM) Volumes 1 and 2, and the International Classification of Diseases, Ninth Revision, Clinical Modification Volume 3 for diagnosis and procedure codes, respectively. HHS notes that the shortcomings of the current ICD-9 system include limited ability to accommodate new procedures and diagnoses; lack of specificity and detail; inconsistent terminology, and lack of codes for preventive services. On the other hand, HHS expects adoption of the ICD-10 code set to support value-based purchasing and reporting of quality data and ensure more accurate payments for new procedures. While HHS believes the new systems will result in significant long-term savings, short-term implementation costs (training, productivity losses, and systems changes) could reach almost $2 billion. The rule is effective October 1, 2013, two years later than provided in the August 22, 2008 proposed rule.
