ICD-10 OVERVIEW - Centers for Medicare & Medicaid Services

嚜澠CD-10 OVERVIEW

History of ICD-9-CM

? Pat Brooks, RHIA

? Senior Technical Advisor

? Centers for Medicare & Medicaid Services

(CMS), Hospital and Ambulatory Policy

Group

E-mail 每 patricia.brooks2@cms.

Pat Brooks, CMS

2

History of ICD-9-CM

? World Health Organization (WHO) developed

ICD-9 for use worldwide

? U.S. developed clinical modification (ICD-9-CM)

每 Implemented in 1979 in U.S.

每 Expanded number of diagnosis codes

每 Developed procedure coding system

Pat Brooks, CMS

3

ICD-9-CM Users

? ICD-9-CM Diagnoses 每 used by all types of

providers

? ICD-9-CM Procedures 每 used only by inpatient

hospitals

? Current Procedural Terminology (CPT) 每 used

for all ambulatory and physician procedure

reporting

Pat Brooks, CMS

4

What is ICD-9-CM Used For?

? Calculate payment 每 Medicare SeverityDiagnosis Related Groups (MS-DRGs)

? Adjudicate coverage 每 diagnosis codes for

all settings

? Compile statistics

? Assess quality

Pat Brooks, CMS

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