decisionhealth Newsletters, Coder Pink Sheets - 2013 Issue 6 (June)
Transition to ICD-10: You won’t have to code external cause unless payer requires it, CMS clarifies
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Article Overview
This article explains CMS guidance for the ICD-10 transition period, with emphasis on external cause reporting, when to code signs and symptoms, use of unspecified diagnoses, and how date of service affects whether ICD-9-CM or ICD-10-CM is used. It is relevant to coders, billers, compliance staff, and practices preparing systems and workflows for the ICD-10 implementation period.
Why This Topic Matters
It highlights transition-period coding and billing considerations that can affect claim accuracy, payer handling, and workflow readiness when moving from ICD-9-CM to ICD-10-CM.
What You Will Learn
- How CMS framed external cause code reporting during the ICD-10 transition
- When signs, symptoms, and unspecified diagnosis codes may be discussed in relation to diagnosis coding
- How date of service affects the selection of ICD-9-CM versus ICD-10-CM
- Why split claims may be needed when services span the transition date
- What operational areas may need to be ready for dual-code-set processing
Who Should Read This
- Medical coders
- Billers
- Coding auditors
- Compliance staff
- Revenue cycle teams
- Provider practices
- Health information management professionals
Codes Discussed
Code Ranges Discussed
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