CMS Issues Alert Regarding Transition to ICD-10 Codes for Section 111 Reporting

The Centers for Medicare & Medicaid Services (CMS) has published a Technical Alert detailing the transition from ICD-9 codes to ICD-10 codes in diagnosis coding and Section 111 reporting. The entire Alert can be found at http://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Mandatory-Insurer-Reporting-For-Non-Group-Health-Plans/Downloads/S111ICD10Alert.pdf.

As noted in our January 3, 2013, newsletter, ICD-10-CM codes are replacing ICD-9-CM codes in Section 111 reporting beginning October 1, 2014. At that time, CMS will begin using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for diagnosis coding. ICD-10-CM codes tend to be more detailed than ICD-9 codes, and contain 3 to 7 digits (instead of the 3 to 5 digits used with ICD-9-CM).

The Technical Alert published on June 11, 2013, provides further technical details regarding the transition from ICD-9-CM to ICD-10-CM codes, how the claim input files will be revised, and which ICD-10 codes will be considered valid. In general, Responsible Reporting Entities (RREs) can begin testing the changes to Section 111 fields on October 1, 2013, and are encouraged to begin using ICD-10 codes on production files on October 1, 2014. For dates of injury on or after April 1, 2015, valid ICD-10 codes must be used on all "add" or "update" records.

Another revision to the User Guide is forthcoming which details these changes. We will let you know when this newer User Guide is published and becomes available.