ICD-10 Replaces 36-year-old ICD-9 in Medical Billing

In October, 2015, for the first time in more than three decades, the American Medical Association (AMA), revised its universal medical billing codes, replacing ICD-9 with ICD-10. Since 1979, physicians, medical secretaries, and other healthcare professionals have used the same set of medical billing codes in ICD-9 and now, the world has to reprogram, rethink, and relearn the nuances of each medical code.

Below are main points regarding the transition for the uninitiated:

  • ICD stands for the “International Classification of Diseases” and this universal classification applies throughout all medical fields.
  • Making the change from ICD-9 to ICD-10 is a federal regulation of the HIPAA (Health Insurance Portability and Accountability Act) The HIPAA was passed in 1996 and its main goal was to assist insureds recover funds from their insurance companies in addition to providing confidentiality regarding health care treatments and diagnoses.
  • Even insurance entities which are not subject to the federal HIPAA, like workers’ compensation, auto, property, and casualty insurance, may be subject to the new code changes under state law.
  • One driving force behind updating the coding system is that there have been new medical treatments and terminology added to the profession. The ICD-10 codes, which number 68,000 adequately cover these updates, while the 14,000 codes in ICD-9 we unable to reflect a patient’s specific medical situation.
  • Any ICD-9 codes used after October 1, 2015 are viewed as noncompliant and will be summarily rejected.

Like most transitions, the change from ICD-9 to ICD-10 has been a difficult one for medical practitioners and their employees across the country. Understanding all the new codes, with their nuances and modern medical terminology gives way to many human errors and frustration in the process. To mitigate the interruption, the AMA has provided implementation resources and educational tools including explanations and contact information to speak with a representative. The AMA hopes ICD-10 will last for many years and that future changes will merely involve additions to the current system, instead of a complete overhaul.

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