Back to Top Skip to main content

Health.mil: the official website of the Military Health System (MHS) and the Defense Health Agency (DHA)

Utility Navigation Links

Social Media Links

Frequently Asked Questions

Sidebar Navigation

Frequently Asked Questions for Code Sets

View questions and answers about the nationwide standards for code sets used in the HIPAA compliant electronic health care transactions.

Recommended Content:

Frequently Asked Questions for Code Sets, Code Sets, Frequently Asked Questions for Code Sets
Q1:

Will ASC X12 Version 5010 of the HIPAA Electronic Data Interchange (EDI) standards be able to accommodate International Classification of Diseases, Tenth Revision (ICD-10)?

A:

Yes, ASC X12 Version 5010 supports ICD-10, Procedure Coding System (PCS) and Clinical Modifications (CM) codes, and is now fully implemented across the industry. Per the Final Rule published by HHS in August 2014, covered entities are required to use ICD-10 in HIPAA transactions by October 1, 2015.

Q2:

What is the MHS' plan for International Classification of Diseases, Tenth Revision (ICD-10)?

A:

In August 2014, the Department of Health and Human Services (HHS) issued a Final Rule establishing October 1, 2015, as the compliance date for use of ICD-10 code sets. The HIPAA Transactions Final Rule also requires continued use of the International Classification of Diseases, Ninth Revision (ICD-9) through September 30, 2015. The MHS has updated policy to account the most recent ICD-10 Final Rule. Providers, insurance companies, and others in the healthcare industry can now focus their efforts on the finalized deadline and concentrate on moving toward industry readiness together for October 1, 2015. To view related TRICARE Regional or Program sites, please see below:

Q3:

Will prior authorizations need to be resubmitted for approval after the International Classification of Diseases, Tenth Revision (ICD-10) implementation date?

A:

Prior authorizations will not need to be resubmitted for approval after ICD-10 implementation. Diagnosis and inpatient procedure codes are not used in authorization-to-claim matching logic, so there is no need for providers to request a new ICD-10 coded authorization if providers have an International Classification of Diseases, Ninth Revision (ICD-9) coded authorization prior to implementation.

Q4:

What International Classification of Diseases, Tenth Revision (ICD-10) training materials will the MHS make available to interested parties?

A:

The DHA's ICD-10 Integrated Project Team (IPT) within the MHS produces the  ICD-10 Training and Communication Newsflash on a bi-monthly schedule. These newsflashes are intended to educate readers on specific ICD-10 topic and provide a starting point on that particular topic. >>Learn More

Q5:

Where can interested parties find additional information about International Classification of Diseases, Tenth Revision?

A:

Additional information on ICD-10 can be found on the Centers for Medicare and Medicaid Services' (CMS') Website:

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.