ICD-10

ICD-10 transition took place on on October 1, 2015. NHRMC took a number of steps to ensure compliance with the federally mandated implementation of ICD-10 codes, which allow for greater specificity and detail in describing a patient's diagnosis and in classifying inpatient procedures.

Congratulations to the Medical Staff and hospital personnel who played an important role in the adoption of ICD-10. The ICD-10 team was instrumental in preparing and supporting physicians and employees throughout this process.

As we go forward, we will continue to provide resources and awareness of our overall progress.

About ICD-10

The International Classification of Diseases, 10th Edition (ICD-10), is the update of diagnosis and procedure codes developed by the World Health Organization. Under federal regulation, ICD10_structureHIPAA covered entities (health care providers, health plans and health care clearinghouses) are required to implement the ICD-10 code sets for electronic transactions for date of service/date of discharge on and after October 1, 2015, to replace the ICD-9 code sets we presently use.

New code set regulations address usage of:

Why is this important to me?

Code sets are one of the fundamental elements of New Hanover Regional Medical Center's business. Insurance companies determine hospital payment amounts based on the ICD-9/ICD-10 codes we apply to our patient cases. To frame the scope of the transition, ICD-9 used about 21,000 diagnosis and procedure codes. In ICD-10, there will be about 155,000 – nearly eight times more than ICD-9. In addition, ICD-10 is fundamentally different in terms of structure and logic. ICD-10 utilizes an alpha-numeric structure that offers significantly more granularity about a patient's medical condition and inpatient hospital procedures.

ICD-10 compliance means that all HIPAA covered entities are able to successfully conduct health care transactions for date of service on or after October 1, 2015, using ICD-10 diagnosis and procedure codes. ICD-9 codes can no longer be used for health care services provided on or after Oct. 1, 2015.

What are the benefits of ICD-10?

In addition to compliance with the federal mandate, ICD-10 allows for greater specificity and detail in describing a patient's diagnosis and in classifying inpatient procedures, so reimbursement and clinical outcomes can better reflect the intensity of the patient's condition and diagnostic needs. Globally there will be improved disease management and coordination of disease monitoring and reporting. ICD-10 also supports value-based purchasing and Medicare's anti-fraud and abuse activities with accurate service definition and specific diagnosis and treatment information.

Where did it come from?

In January 2009, provisions of the Health Insurance Portability and Accountability Act (HIPAA), issued the final rule mandating all covered entities (health care providers, health plans and health care clearing houses) comply with new code set regulations regarding the International Classification of Diseases, 10th Edition (ICD-10), for all covered electronic transactions for dates of service on and after October 1, 2015.