ICD-10 Basics: What is ICD-10?

The International Classification of Diseases, 10th Edition (ICD-10) consists of two components; (1) ICD-10 CM for diagnosis coding and (2) ICD-10 PCS for inpatient procedure coding.

Current Procedural Terminology (CPT) codes will continue to be utilized by provider practices for procedure coding. Therefore, our focus is on ICD-10_CM diagnosis codes used to report diagnoses. Diagnosis codes provide the “why” explanation for the service rendered.

Basic facts about ICD-10-CM, which we’ll refer to as ICD-10:

  • Codes are 3-7 digits in length
  • There is no 1:1 mapping
  • Codes include laterality, anatomic specificity, episode of care, severity and other concepts that allow for greater specificity
  • The letter X is used as a placeholder in certain codes to allow for future expansion
  • ICD-9 is outdated and inconsistent with current medical practice and terminology
  • Claims submitted with improper or outdated codes after the October 1, 2015 deadline will not be paid

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