A last-minute guide to the ICD-9 to ICD-10 transition

Last updated:September 2015

Editor's note

Beginning on Oct. 1, 2015, the U.S. healthcare industry must cease using ICD-9 codes to categorize and document patient treatment and convert to the larger ICD-10 code set. The American version of the newer coding set, ICD-10-CM, consists of 68,000 codes -- a dramatic increase from the 13,000 codes that make up ICD-9-CM. Some providers readied their practices to make the transition to ICD-10 by the previous 2014 deadline, while others took the second delay as an opportunity to perform more coding tests and evaluate their staffs' readiness. There remain providers that are unsure it will be business as usual for their practice post-ICD-10 implementation. In this guide, IT experts explain which healthcare facilities are feeling the pressure of moving from ICD-9 to ICD-10 and how they got in that position.

Not everyone is feeling trapped by ICD-10. To aid providers converting from ICD-9 to ICD-10, CMS announced that for the first year after the ICD-10 implementation date, providers won't be charged with improper coding as long as a valid code from the proper code family -- if not the specific code -- is used. The stories in this guide illustrate exactly how providers arranged all aspects of their medical and business workflows to apply to ICD-10, complete with specific examples and tips from hospital CIOs.

1ICD-10 coding preparation and adjustments

Four state Medicaid programs were recently granted the right to use coding crosswalks after the ICD-10 deadline. Other providers were given a break by CMS when it said coders wouldn't be penalized for not using the exact ICD-10 code for a year after the implementation date. Not all providers are relying on those exceptions to navigate through the ICD-9 to ICD-10 conversion period. Read on to find out which claims providers tested more than others, as they adjusted their coding operations to suit ICD-10.

2The struggles of adopting ICD-10

Physicians at small practices aren't the most confident bunch, as October approaches. Some of them aren't sure how their EHRs and billing software will cooperate with ICD-10, because they've been unable to run tests between the two systems. Whether the technology and physicians are ready or not, ICD-10 is coming, and there will be no going back once it's here.