The Myths vs. the Facts Regarding ICD-10


The following are some clarification of myths from Medical Economics that are circulating about the upcoming transition to ICD-10:

Myth: ICD-10 contains ten times the number of codes featured in ICD-9

Fact: ICD-10 has 69, 832 diagnosis codes, while ICD-9 has 14, 567 diagnosis codes. ICD-10 has 71, 920 procedure codes, and ICD-9 has only 3,878 procedure codes. Distinctions between left and right account for 25, 626 of the new codes in ICD-10, and there are 39, 869 injury/poison codes in ICD-10, as opposed to 2,587 in ICD-9. All providers (hospitals and doctors) will use the diagnosis codes, but only hospitals reporting inpatient procedures will use the procedure codes.

Myth: ICD-10 only applied to those who submit Medicare and Medicaid claims

Fact: ICD-10 affects everything in healthcare covered by the Health Insurance Portability and Accountability Act.

Myth: Payers will not be ready for the transition

Fact: On June 2nd, the CMS announced its 2nd end-to-end testing with the Medicare fee-for-service providers, and about 875 providers and billing companies participated. 88% of the 23,000 test claims were accepted.

Myth: ICD-10 was developed without input from physicians

Fact: The CMS says that the ICD-10 codes involved "significant clinical input" from numerous specialty societies.

Myth: ICD-10 will be delayed past its October 1st, 2015 implementation date.

Fact: There is the Cutting Costly Codes Act of 2015 in the U.S. House of Representatives that has the potential to block the October 1st deadline. Experts do not believe that the bill will advance. Meanwhile, the House Ways and Means health subcommittee is designing a contingency plan for the CMS, if it cannot handle the new set of codes in October.

Written by Caroline Smith

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Caroline Smith is currently a senior at the University of Notre Dame and is a contributor to Medical Groups. She is majoring in Science-Business and Spanish. After graduation, Caroline plans on entering the field of healthcare consulting. She is most interested in the evolving policy changes in the healthcare industry and enjoys learning about new technologies that are being developed.