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- ICD-9 is outdated and inconsistent with current medical practice and terminology
- Claims submitted with improper or outdated codes after the October 1, 2015 deadline will not be paid
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