ICD-10-CM FAQs

The ICD-10 codes replaced ICD-9 as the updated code set for all HIPAA transactions. Below, physicians and their staff can find ICD-10 coding and implementation frequently asked questions. Please watch for updates to these coding FAQs as information becomes available.

What is the official implementation date of ICD-10-CM?

CMS announced the official implementation date of ICD-10-CM as October 1, 2015.

Will there be a transition period to submit ICD-9 and ICD-10?

No, there have been no indications that practices will have any transition period.

Who is affected by the transition to ICD-10?

No one is excluded from the conversion. Every health care provide, payer or entity covered by HIPAA must have transitioned to the new ICD-10 code set on October 1, 2015.

Why did the code set change from ICD-9 to ICD-10?

ICD-9 was developed in the 1970s. After 30 years the system was running out of codes and through the system structure it would not be able to hold more codes that would be needed in the future.

There are two parts to ICD-10; will rheumatologists use both of them?

No, physicians will only use the ICD-10-CM. The other part is ICD-10-PCS ,which is the procedural coding system section for hospitals to report the resources to treat inpatient cases.

Will coders need to be retained or recertified to use ICD-10?

Coders will not have to be recertified to keep their current credentials but will have to pass an ICD-10 aptitude test to confirm their ability to properly use the new code set with accuracy.

Won’t my EHR be able to code ICD-10 for me?

EHRs should have all the necessary codes in your system and may have the ability to assist you with selecting a code for a specific condition, but it is unclear if it will be able to instruct you on what else is needed to implement ICD-10 in your practice or the specific guidelines surrounding the codes.

What are the key elements I will need to include in my documentation?

Because ICD-10 is more robust and requires patient specific information, documentation is the key. It will be important to include details such as laterality, severity of illness, anatomic site and etiology. If the documentation is not complete and does not provide the necessary information, it will be difficult to code the highest level of specificity which could have an impact on reimbursement.

Will the ACR have a crosswalk of the most common codes that affect rheumatology?