Transitioning to ICD-10

The U.S. Department of Health and Human Services (HHS) has adopted a rule to replace the currently used International Classification of Diseases, 9th Revision (ICD-9) with the next-generation ICD-10 code sets by October 1, 2015.

Compliance dates

Outpatient claims: All outpatient claims with dates of service on or after October 1, 2015, must be submitted with ICD-10 codes.

Inpatient claims: All inpatient claims with discharge dates on or after October 1, 2015, must be submitted with ICD-10 codes.

Claims that are submitted with non-compliant ICD-9 codes after this date will be rejected.

How to prepare

All health care providers should be in compliance with HIPAA 5010 transaction and code set requirements as a prerequisite for the conversion to ICD-10. Physician practices and facilities should create an ICD-10 implementation plan that includes an awareness campaign and an education strategy. In addition, AmeriHealth New Jersey urges you to complete an impact assessment of the ICD-10 transition.

What will change?

Diagnosis codes (ICD-10-CM) and procedure codes (ICD-10-PCS) will have more digits than ICD-9 codes; CPT® and HCPCS codes will not be affected.

The number of codes will increase significantly from roughly 14,000 codes to 170,000 codes.

The new ICD-10 codes:

  • Use updated and more precise medical terminology;
  • Enable laterality;
  • Allow for the ability to add new codes;
  • Include greater specificity (including a greater number of digits);
  • Provide more detailed clinical information about conditions, diseases, and injuries.

The implementation of ICD-10 will result in more accurate coding, which will improve the ability to measure health care services, enhance the ability to monitor public health, improve data reporting and reduce the need for supporting documentation when submitting claims.

Please visit AmeriHealth's Claims and Billing page frequently for updated information on ICD-10.

View the Transition to ICD-10 FAQ

ICD-10 Spotlight: Know the Codes Booklet

Throughout 2012, our Partners in Health UpdateSM newsletter ran a series of articles featuring various examples of how ICD-9 codes will translate to ICD-10 codes. These articles explored various coding conventions, general guidelines, and chapter-specific guidelines in ICD-10. We've compiled all the articles into the below booklet for your reference. ICD-10 spotlight: Know the codes

Putting ICD-10 into Practice: Coding exercises and scenarios

Throughout 2013, our Partners in Health UpdateSM newsletter featured a series of articles in preparation for the transition to ICD-10. Each month we published coding exercises and scenarios to help you put into practice the new guidelines and conventions you learned about in the ICD-10 Spotlight: Know the codes series. The booklet below includes all of these coding exercises and scenarios for your reference. Putting ICD-10 into Practice: Coding exercises and scenarios