The Department of Health and Human Services (HHS) on Aug. 15 announced a long-awaited proposed regulation that would replace the ICD-9-CM code sets now used to report healthcare diagnoses and procedures with greatly expanded ICD-10 code sets, effective Oct. 1, 2011. In a separate proposed regulation, HHS has proposed adopting the updated X12 standard, version 5010, and the National Council for Prescription Drug Programs standard, version D.0, for electronic transactions, such as healthcare claims. Version 5010 is essential to use of the ICD-10 codes.
Developed almost 30 years ago, ICD-9 is now widely viewed as outdated because of its limited ability to accommodate new procedures and diagnoses. ICD-9 contains only 17,000 codes and is expected to start running out of available codes next year. By contrast, the ICD-10 code sets contain more than 155,000 codes and accommodate a host of new diagnoses and procedures. The additional codes will help to enable the implementation of electronic health records because they will provide more detail in the electronic transactions. This granularity will also help to improve efficiencies by helping to identify specific health conditions such as methicillin-resistant Staphylococcus aureus and other conditions.
Under the updated transaction standards proposed rule, compliance with version 5010 (health care transactions) and Version D.0 (pharmacy claims) would be required by April 1, 2010. In that rule, a standard for the Medicaid pharmacy subrogation transaction is also proposed. Comments on both proposed rules are due by Oct. 21, 2008. Read the press release.
