Revenue Cycle Management Blog | GroupOne Health Source

Will Your Patients Have a New Diagnosis on October 1st?

Written by Jessica Graham | September 5, 2008

The National Center for Health Statistics (NCHS) and the Centers for Medicare & Medicaid Services (CMS), have issued a record number of new diagnosis and procedure codes for the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9- CM) every year since 1986.

Medicare Contractor Annual Update of the International Classification of
Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)  

Provider Types Affected

Physicians, suppliers, and providers billing Medicare contractors (carriers, Part A/B
Medicare Administrative Contractors (A/B MACs), Durable Medical Equipment Medicare
Administrative Contractors (DMACs), and fiscal intermediaries (FIs) including regional
home health intermediaries (RHHIs)).

Impact on Providers 

This article is based on Change Request (CR) 6107 and reminds the Medicare contractors
and providers that the annual ICD-9-CM update will be effective for dates of service on and
after October 1, 2008 (for institutional providers, effective for discharges on or after
October 1, 2008). You can see the new, revised, and discontinued ICD-9-CM diagnosis
codes on the Centers for Medicare & Medicaid Services (CMS) website at
http://www.cms.hhs.gov/ICD9ProviderDiagnosticCodes/07_summarytables.asp#TopOfPage,
or at the National Center for Health Statistics (NCHS) website at
http://www.cdc.gov/nchs/icd9.htm  in June of each year.

Background 

The ICD-9-CM codes are updated annually as stated in the Medicare Claims Processing
Manual, Chapter 23 (Fee Schedule Administration and Coding Requirements), Section
10.2 (Relationship of ICD-9-CM Codes and Date of Service). 

CMS issued CR 6107 as a reminder that the annual ICD-9-CM coding update will be
effective for dates of service on or after October 1, 2008 (for institutional providers,
effective for discharges on or after October 1, 2008). 

Remember that an ICD-9-CM code is required for all professional claims (including
those from physicians, non-physician practitioners, independent clinical diagnostic
laboratories, occupational and physical therapists, independent diagnostic testing
facilities, audiologist, ambulatory surgical centers (ASCs)), and for all institutional
claims; but is not required for ambulance supplier claims.

Additional Information

The official instruction (CR 6107) issued to your Medicare contractor is available at
http://www.cms.hhs.gov/Transmittals/downloads/R1566CP.pdf on the CMS website.

As mentioned, you can find the new, revised, and discontinued ICD-9-CM diagnosis codes
at
http://www.cms.hhs.gov/ICD9ProviderDiagnosticCodes/07_summarytables.asp#TopOfPage 
on the CMS website or at the National Center for Health Statistics (NCHS) Web site at
http://www.cdc.gov/nchs/icd9.htm , in June of each year. The annual ICD-9-CM code
changes are also included in a CD-ROM, which you can purchase for $25.00 from the
Government Printing Office (GPO), stock number 017-022-01573-1. 

To learn more about ICD-9-CM codes, you might want to read Medicare Claims
Processing Manual, Chapter 23 (Fee Schedule Administration and Coding Requirements),
Section 10.2 (Relationship of ICD-9-CM Codes and Date of Service); or look at the
information provided at
http://www.cms.hhs.gov/ICD9ProviderDiagnosticCodes/01_overview.asp#TopOfPage  on
the CMS website.

If you have questions, please contact your Medicare contractor at their toll-free number
which may be found at
http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip on the
CMS website.