Data Innovations - ICD-10-CM/PCS Resources

The International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) code sets are scheduled to replace the current ICD-9-CM coding system beginning October 1, 2015. Changes in this new code set allow greater data specificity and provide more future expansion capabilities than were possible with ICD-9-CM:

Added information relevant to ambulatory and managed care encounters
Expanded injury codes
Combined diagnosis and symptom codes to reduce the number of codes needed to fully describe a condition
Addition of sixth and seventh characters
Incorporation of common fourth and fifth digit sub-classifications
Laterality (e.g., designation of left or right side when describing locations of injuries)
Greater specificity in code assignment.

On January 16, 2009, the Department of Health and Human Services (HHS) published a final rule adopting ICD-10-CM (and ICD-10-PCS) as replacements for ICD-9-CM/PCS in Health Insurance Portability and Accountability Act (HIPAA) transactions, with an initial implementation date of October 1, 2013. The implementation of ICD-10-CM/PCS was delayed to October 1, 2014 by final rule CMS-0040-F, issued on August 24, 2012. However, adoption of ICD-10-CM/PCS by the Secretary prior to October 1, 2015 was further delayed with enactment of the Protecting Access to Medicare Act (PAMA) of 2014 (Pub L No 113-93). This law restricts implementation prior to that date and also requires HIPAA-covered entities to continue to use ICD-9-CM through September 30, 2015. This ICD-10-CM/PCS Resources page contains materials that health care data organizations may find useful as they prepare for the transition.

Quick View Comparison of ICD-9-CM and ICD-10-CM/PCS

	ICD-9-CM	ICD-10-CM/PCS
ICD-9-CM and ICD-10-CM/PCS Code Sets
Diagnosis	14,025 codes	68,069 codes
Procedures	3,824 codes	72,589 codes
ICD-10-CM/PCS Code Structure Changes (selected details)
Diagnosis Structure	3-5 characters First character is numeric or alpha Characters 2–5 are numeric	3-7 characters Character 1 is alpha Character 2 is numeric Characters 3–7 can be alpha or numeric
Procedure Structure	3-4 characters All characters are numeric All codes have at least 3 characters	ICD-10-PCS has 7 characters Each can be alpha or numeric Numbers 0–9; letters A–H, J–N, P–Z
Source: Centers for Disease Control and Prevention. The ICD-10 Transition and Public Health Surveillance – What You Need to Know. Table 1. Key Differences Between Code Sets. December 2013. http://www.cdc.gov/nchs/icd/data/CDC_ICD-10_Transition_FactSheet_12_2013.pdf

ICD-9-CM

ICD-10-CM/PCS

ICD-9-CM and ICD-10-CM/PCS Code Sets

Diagnosis

14,025 codes

68,069 codes

Procedures

3,824 codes

72,589 codes

ICD-10-CM/PCS Code Structure Changes (selected details)

Diagnosis Structure

3-5 characters
First character is numeric or alpha
Characters 2–5 are numeric

3-7 characters
Character 1 is alpha
Character 2 is numeric
Characters 3–7 can be alpha or numeric

Procedure Structure

3-4 characters
All characters are numeric
All codes have at least 3 characters

ICD-10-PCS has 7 characters
Each can be alpha or numeric
Numbers 0–9; letters A–H, J–N, P–Z

Source: Centers for Disease Control and Prevention. The ICD-10 Transition and Public Health Surveillance – What You Need to Know. Table 1. Key Differences Between Code Sets. December 2013. http://www.cdc.gov/nchs/icd/data/CDC_ICD-10_Transition_FactSheet_12_2013.pdf