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The ICD-10-CM code sets, which report diagnoses and inpatient procedures, replaced ICD-9-CM in 2015. The transition affects all entities and providers covered by the Health Insurance Portability Accountability Act. ICD-10 -CM coding may be challenging for providers, not the least because the codes are recorded on so many types of health records and are a key component in payment, quality, utilization review, and other data management activities.
ICD-10-CM codes are updated annually, and the current year’s codes are to be used for discharges and patient encounters occurring from October 1 of the current year through September 30 of the following year. CMS’ ICD-10 webpage links to ICD-10-CM codes for current and previous years.
Identifying the Correct Codes for the Current Year
Access guidelines and information on how to identify the correct codes for ICD-10.
CMS Guidance
Introduction to ICD-10
- ICD-10 Webpage at CMS.gov
Includes news, email updates, and downloadable files of the codes.
- Provider Resources for ICD-10
Includes info on the ICD-10 transition, including an introduction, implementation guides, timelines, checklists, and webinars.
Medicare Reimbursement
- Review Contractor Directory (Interactive Map)
Your Medicare Administrative Contractor is your first contact for quick support regarding Medicare claims and questions. Find your MAC contact via the map.
- Email CMS Regarding ICD-10
Email the CMS ICD-10 Coordination Center with concerns or questions regarding ICD-10 coding.
- Email the ICD-10 Ombudsman
The ombudsman serves as an impartial advocate for providers, focused on understanding and resolving your concerns.