Prior Authorization & Claims

ICD-10

Transitioning to ICD-10

The transition from ICD-9 to ICD-10 went into effect on October 1, 2015. To help ensure you are ready, here are some things to remember:

  • Make sure your practice management system and/or billing system is ICD-10 ready. Talk with your vendor about the support and services you might need to be compliant for ICD-10.
  • There is no need to memorize all of the new ICD-10 diagnoses. If you are not an inpatient facility, you only need to be concerned with the most common medical conditions your practice sees today and understand how ICD-10 impacts them.
  • If you rarely see a particular ailment, there is no need to memorize it or convert it to the ICD-10 equivalent diagnosis code on your paper super bill or problem list in your electronic medical record.
  • If your practice treats a wide range of medical conditions, use the 80/20 rule to determine which diagnosis ICD-10 codes are most pertinent. This would include family practice, pediatric medicine or internal medicine.

The Centers for Medicare & Medicaid Services offers the “Road to ICD-10” — a comprehensive tool with which you can explore common codes, primers for clinical documentation, clinical scenarios and additional resources associated by specialty.

Visit www.roadto10.org to find information for:

Questions or Comments?

If you have questions or need help with any other item, contact your local Provider Relations representative or call Provider Services.

Page Last Updated: 04/01/17

ICD-10 Resources

We encourage all providers to check with CMS and any professional, clinical and trade associations in which you may be affiliated for a wide variety of ICD-10 information, educational resources, checklists and updates to assist you with this transition.

Web Resources