Texas Medicaid and CHIP - ICD-10

ICD-10 Background

On Oct. 1, 2015, all HIPAA covered entities will make the transition to ICD-10 for the submission of claims using diagnosis and inpatient procedure codes. The shift from ICD-9 to ICD-10 is intended to allow for greater specificity in describing diagnoses and procedures. Healthcare professionals will have the opportunity to use further detail when tracking medical conditions. 

Transition to ICD-10

The transition to ICD-10 is occurring because the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) is 30 years old, has outdated terms, and is inconsistent with current medical practice. ICD-9 reports non-specific data about patients’ medical conditions and hospital inpatient procedures. Also, the structure of ICD-9 limits the number of new codes that can be created, and many ICD-9 categories are full. Because ICD-10 codes are more specific, they will allow for better analysis with disease and public health patterns, in addition to providing for expansion.

ICD-10 Resources

Managed Care Organizations