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ICD-10

For the latest information about the ICD-10 implementation for NCTracks, see the NCTracks ICD-10 webpage.

CMS published the original rule on January 16, 2009 - HIPAA Administrative Simplification: Modifications to Medical Data Code Set Standards to Adopt ICD-10-CM and ICD-10-PCS. The rule was revised and a final rule was posted August 24, 2012 that requires all HIPAA covered entities to adopt the ICD-10 code sets which replaces the ICD-9 code sets with a compliance date of October 1, 2014 - Administrative Simplification: Change to the Compliance Date for the International Classification of Diseases, 10th Edition (ICD–10–CM and ICD–10–PCS) Medical Data Code Sets.

ICD-10 code sets contain greater clinical detail and specificity which supports the collection of improved clinical information. The number of diagnosis/procedure codes is greatly expanded (from about 17,000 to over 150,000 codes). ICD-10 will provide a number of advantages such as:

  • Improved claims payment accuracy and efficiency
  • Improved accuracy of quality measures
  • Reduced need for attachments to explain the patient's condition
  • Detailed clinical information in a single ICD-10 procedure code
  • Improved tracking of public health measures and population epidemiologic research
  • Better identification of risk and severity
  • Expanded flexibility for coding new diseases and medical procedures in future

Providers and other trading partners must fully understand where and how ICD-9 codes are used within their organizations so the new ICD-10 code sets can be implemented properly within their business and billing practices.

As NC DHHS OMMISS ICD-10 project implementation activities progress for NCTracks, we will keep our trading partners informed and assist in providing meaningful resources to ensure implementation by the compliance date.


NC DHHS ICD-10 Implementation Project

OMMISS – in cooperation with the Division of Medical Assistance (DMA), the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (DMHDDSAS) and the Division of Public Health (DPH) – is currently working to identify where ICD codes are used within DHHS policies processes and systems. We are identifying the work effort required to transition to ICD-10 as well as the tasks necessary to remediate the replacement MMIS NCTracks. Below is an overview of our implementation timeline and activities:

Phase 1 - 4th Qtr 2011 - 2nd Qtr 2012:

  • Historical claim and data analysis
  • Conduct Mapping (ICD-9 to ICD-10 using GEMS) Activities
  • Create Project Plan for ICD-10 Phase 2 and Phase 3 Activities

Phase 2 – 2nd Qtr 2012 – 3rd Qtr 2013:

  • Remediate policies, business rules, edits and audits, and reports
  • Remediate business process manuals
  • Implement Communication Plan Activities

Phase 3 – 2nd Qtr 2013 – 2nd Qtr 2014:

  • Develop Technical Design for NCTracks Remediation
  • Remediate NCTracks including revised audits/edits/reports
  • Perform Internal Testing

Phase 4 – 3rd Qtr 2013 – 3rd Qtr 2014:

  • Perform Internal and External Training
  • Perform External Testing

If you have questions related to the NC DHHS implementation project, please send an email to OMMISS.ICD10@dhhs.nc.gov


ICD-10 Helpful Links

The following links take you to documents and websites that offer ICD-10 training and educational opportunities:

http://www.cms.gov/ICD10/ This website provides resources and timelines to assist providers, payers and vendors with the U.S. health care industry’s transition to ICD-10.

http://www.cms.gov/ICD10/Downloads/ICD10FAQs.pdf. ICD-10 Compliance Fact Sheet or FAQs

http://www.nchica.org/HIPAAResources/icd10.htm. This website provides resources developed by the North Carolina Healthcare Information and Communications Alliance, Inc. (NCHICA) to assist with ICD-10 implementation efforts

http://wedi.org/public/articles/dis_viewArticle.cfm?ID=904. This service offered by the Workgroup for Electronic Data Interchange (WEDI) connects the healthcare community with vendors providing ICD-10 implementation and training services.

http://www.ahima.org/icd10/. This series of links takes you to training from the American Health Information Management Association (AHIMA).

http://www.himss.org/ASP/topics_FocusDynamic.asp?faid=473. This website offered by the Health Information and Management Systems (HIMSS) provides information on system remediation plan development, ICD-10 testing, software tools, how to select vendor partners, staff training plan, change management, communications and education plan as well as the Go Live plan.

http://apps.who.int/classifications/apps/icd/icd10training/. This website offers self-directed training for various users of the ICD-10 codes.

http://edocket.access.gpo.gov/2009/pdf/E9-743.pdf. This legislation governs the implementation of ICD-10.

Note: The previous information is published by entities other than the NC DHHS. The State of North Carolina, its agencies, and agents are not responsible for the content.


ICD-10 listserv

If you would like to be added to the ICD-10 listserv, please click here to join.

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