HCIM

CMS Progress in Implementing the New Standards
CMS is well into the process of readying its FFS Medicare systems to handle the 5010/D.0 standards. All Medicare systems will be ready to handle the new standards by January 1, 2011. Medicare plans for its systems to handle the current 4010A standard and the new 5010/D.0 standards for [...]

Why the change from 4010A to 5010?
Key issues for adapting HIPAA 5010 rules are:

To accommodate ICD-10 coding.
4010 technology is outdated. It has been in use for five years and was written three years prior to that.
Many of the situational and required rules did not fit health care industry practices. This is especially true for the 278, [...]

What is HIPAA?
HIPAA, which stands for the American Health Insurance Portability and Accountability Act of 1996, is a set of rules to be followed by doctors, hospitals and other health care providers. HIPAA took effect on April 14, 2006. HIPAA helps ensure that all medical records, medical billing, and patient accounts meet certain consistent standards [...]

Timeline
The implementation date for ICD-10 is October 1, 2013, and applies to all encounters and discharges occurring on or after that date. According to data from AHIMMS, one entity cannot force another entity to be compliant prior to the said date, although testing will require a great deal of communication between providers, suppliers, and insurers. [...]

ICD–10 consists of:

tabular lists containing cause-of-death titles and codes (Volume 1)
inclusion and exclusion terms for cause-of-death titles (Volume 1)
description, guidelines, and coding rules (Volume 2)
an alphabetical index to diseases and nature of injury, external causes of injury, table of drugs and chemicals (Volume 3)

ICD–10 Chapter Headings:

Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99)
Chapter 2: Neoplasms [...]

ICD–10–CM Diagnosis Codes
The CDC’s National Center for Health Statistics (NCHS) developed the ICD–10–CM code set, following a voluntary consensus-based process and working closely with specialty societies to ensure clinical utility and subject matter expert input into the process of creating the clinical modifications, with comments from a number of prominent specialty groups and organizations that [...]

Key issues in adopting ICD-10- CM are:
• ICD-9 is 30 years old and is outdated.
• ICD-9 is running out of spaces for new codes. Codes added in recent years are in the wrong chapters because the correct chapters were full, with nowhere to add new codes.
• ICD-9 codes cannot reflect current and evolving medical technologies.
• The current codes are limited in their descriptions. New codes will allow for a greater level of detail, including etiology, manifestation, and laterality.
• ICD-9 does not provide the increased level of detail needed for emerging needs like biosurveillance and competitive purchasing. [...]

In many ways, ICD-10-CM is quite similar to ICD-9-CM. The guidelines, conventions, and rules are very similar. The organization of the codes is also very similar. Anyone who is qualified to code ICD-9-CM should be able to easily make the transition to coding ICD-10-CM.
Many improvements have been made to coding in ICD-10-CM. For example, a [...]

The 10th revision of the International Classification of Diseases consists of:
• a tabular list containing cause of death titles and codes
• inclusion and exclusion terms for cause of death titles
• an alphabetical index to diseases and nature of injury, external causes of injury, table of drugs, and chemicals
• descriptions, guidelines, and coding rules

ICD-10 has two components:

The International Classification of Diseases (ICD) is the international standard diagnostic classification for all general epidemiological purposes, many health management purposes, and for clinical use. This includes the analysis of the general health situation of population groups, as well as monitoring the incidence and prevalence of diseases and other health problems in relation to other [...]