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Medical International Statistical Classification of Diseases and Related Health Problems Version 10 Info


What is Medisoft ICD-10?:

ICD 10 is the new diagnosis classification system developed by the World Health Organization, and is being adopted by the American Medical Association and required by Medicare for national implementation.


How Will ICD-10 Be Used?


ICD-10 will be used by both hospitals and institutions (UB04 billing), as well as individual doctors and other medical professionals providing service and billing electronically or on the CMS 1500 form.  There several sub-categories of ICD-10:


  • ICD-10-CM (diagnoses) will be used by all providers in every health care setting
  • ICD-10-PCS (procedures) will be used only for hospital claims for inpatient hospital procedures.   ICD-10-PCS is for use in U.S. inpatient hospital settings only. ICD-10-PCS uses 7 alphanumeric digits instead of the 3 or 4 numeric digits used under ICD-9-CM procedure coding. Coding under ICD-10-PCS is much more specific and substantially different from ICD-9-CM procedure coding.


  • ICD-10-PCS will not be used on physician claims, even those for inpatient visits

Will Medisoft be ICD10 Compliant?


Medisoft v19 will be compliant and readiness can be purchased now thru our Medisoft Network Professional subscription plan.


ICD-10 Transition Timeline


October 1, 2011 – ICD-9-CM and ICD-10 code sets freeze


October 2012 – Limited code updates to both ICD-9-CM and ICD-10 code sets to capture new technology and new diseases


October 1, 2013 – Compliance date for implementation of ICD-10-CM (diagnoses) and ICD-10-PCS (procedures)


Other Dates Based on Date of Service



What is the Difference Between ICD-9 vs. ICD-10?


Implementation of the ICD-10 code sets will expand the number of diagnosis codes from 14,000 to approximately  69,000 and  the number of inpatient procedure codes will grow from almost 4,000 to an estimated 72,000.


The new coding system will require more specific document from physicians about the care provided to patients. For example, ICD-10 has added "laterality" (i.e. distinguishing between left and right) to its structure.


Thus, not only will physicians will need to document this detail, but coders and other individuals that work with ICD codes will need to understand basic anatomy and physiology.


Why do we need to change at all from ICD-9 to ICD-10?


The transition to ICD-10 is occurring because ICD-9 produces limited data about patients’ medical conditions and hospital inpatient procedures. ICD-9 is 30 years old, has outdated terms, and is inconsistent with current medical practice. Also, the structure of ICD-9 limits the number of new codes that can be created, and many ICD-9 categories are full.



Benefits of ICD-10


ICD-10 provides more specific data than ICD-9 and better reflects current medical practice. The added detail embedded within ICD-10 codes informs health care providers and health plans of patient incidence and history, which improves the effectiveness of case-management and care-coordination functions. Accurate coding also reduces the volume of claims rejected due to ambiguity. Here the new code sets will:


  • Improve operational processes across the health care industry by classifying detail within codes to accurately process payments and reimbursements.
  • Update the terminology and disease classifications to be consistent with current clinical practice and medical and technological advances.
  • Increase flexibility for future updates as necessary.
  • Enhance coding accuracy and specificity to classify anatomic site, etiology, and severity.
  • Support refined reimbursement models to provide equitable payment for more complex conditions.
  • Streamline payment operations by allowing for greater automation and fewer payer-physician inquiries, decreasing delays and inappropriate denials.
  • Provide more detailed data to better analyze disease patterns and track and respond to public health outbreaks.
  • Provide opportunities to develop and implement new pricing and reimbursement structures including fee schedules and hospital and ancillary pricing scenarios based on greater diagnostic specificity.
  • Provide payers, program integrity contractors, and oversight agencies with opportunities for more effective detection

Can you show me an example of what a ICD 10 code looks like?


Sample code2

OLD ICD-9 Code

813.15, Open fracture of head of radius

NEW ICD-10 Code

S52123C, Displaced fracture of head of unspecified radius, initial encounter for open fracture


General Equivalency Mappings (GEMs)


General Equivalence Mappings (GEMs) attempt to include all valid relationships between the codes in the ICD-9-CM diagnosis classification and the ICD-10-CM diagnosis classification. The tool allows coders to look up an ICD-9 code and be provided with the most appropriate ICD-10 matches and vice versa. Although, GEMs are not a "crosswalk" and are merely meant to be a guide. Users should exercise clinical judgment when choosing the appropriate code or codes to map between ICD-9 and ICD-10 in either direction. The GEMs are a very useful tool, but it is not a substitute for a complete system change over to ICD-10.

Is ICD-10 substantially different from ICD-9?


For more information from Medicare, please visit this site:  Medicare ICD-10 Information Site

Additional Resources:


13 Tips to Get Started With ICD-10

Top ICD10 Myths and Facts:

ICD-10 FAQ's:

ICD-10 Introduction:

ICD-10 Basics:

Checklist for Small to Medium sized Medical Practices:

Checklist for Large Practices:

Timeline for ICD-10 Implementation for Small To Medium Sized HealthCare Offices:

Timeline for ICD10 Implementation for Large Practices:

Guide for Implementing ICD-10 In a Small to Medium Sized Medical Practice:

Guide for Implementing ICD-10 In Large Medical Specialty Clinic:

ICD-10 Training Webinar From CMS and AAPC: ICD-10 Code A Thon Webinar from CMS and AAPC; this section was presented by CMS:

ICD-10 Code A Thon Webinar from CMS and AAPC; this section was presented by the AAPC;

ICD-10 Code A Thon webinar from CMS and AAPC; Official Transcript:

Additional Resources:
The 5 Phases of ICD-10 Implementation for Physician Practices
The ICD-10 Transition: A Phased, Measured Approach for Physician Practices
ICD-10 and Gunga Galunga, The Gift That Keeps on Giving
ICD-10 and the 5 Stages of Grief
It's About Time
Let the Games Begin!
Now is Not the Time to Implement, Now is the Time to Learn
The Feds Got it Right....This Time
Why is ICD-10 So Hard to Get Done? I'm Livid
Giving Thanks to the ICD-10 Moms
Twas the Night Before ICD-10
They Burned the Boats!


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