Preparing for International Classification of Diseases 10th Revision (ICD-10)

The healthcare industry is transitioning from ICD-9 diagnosis codes to the ICD-10 system, and we're working to provide a seamless transition.

Congress has passed the Protecting Access to Medicare Act of 2014 bill. The legislation implements a new market-based system for Medicare payments for clinical laboratory tests and remove CMS’s authority to implement adjustments to the Clinical Laboratory Fee Schedule (“CLFS”) based on “technological changes.” It also delays implementation of ICD-10 for an additional year, until October 1, 2015, overrides the Sustainable Growth Rate (“SGR”) formula through March 31, 2015, and provides additional mechanisms to adjust code pricing to address misvalued codes under the Medicare Physician Fee Schedule (“PFS”).

We will continue to work diligently to ensure that our customers experience a seamless transition, with the new effective date, without disruption to the quality patient service and laboratory testing you've long trusted us to provide.

Accurate and complete ICD codes are important for proper claims processing

As a healthcare professional, you know that clinical laboratories are required to submit accurate and complete diagnosis codes in electronic and paper claims to third party payers. With ICD-10 comes greater specificity, including age and gender related codes. Claims with insufficient diagnosis coding can trigger denials, requiring both the lab and the provider to invest labor and time to resolve and, very often, creating inconvenience for the patient. It is imperative that the most specific ICD-10 code is provided to avoid these scenarios.

Resources are available to help you prepare

Any healthcare organization required to use diagnosis coding should conduct a full impact assessment in preparation for the transition to ICD-10, as its effects will span well beyond billing or IT areas of your operation. We encourage our customers to develop and implement comprehensive plans and timelines for ICD-10 preparedness, so that when the change occurs on October 1, 2015, you can focus on what is most important, the health of your patients.

In preparation for the ICD-10 changes, information and guidance for the new diagnosis coding can be found in the links below.

To find additional information about ICD-10-CM/PCS, visit the Centers for Medicare & Medicaid Services.

CMS Overview and Quick Reference Information

Additional links: