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Frequently Asked Questions

Why are we changing from ICD-9 to ICD-10 codes?
On Jan. 16, 2009, the U.S. Department of Health and Human Services published the final rules for the modification to the Health Insurance Portability and Accountability Act (HIPAA) electronic transaction and codes set standards. Modifications to the HIPAA code set standards include implementation of ICD-10.

What is the deadline for changing to ICD-10?
All health care providers that bill for Medicare services mush begin using the ICD-10 code set on Oct. 1, 2014.

What happens if we don’t switch to ICD-10?
Claims for all services and hospital inpatient procedures performed on or after Oct. 1, 2014 must use the ICD-10 diagnosis and inpatient procedure codes. Claims that do not use ICD-10 diagnosis and inpatient procedure codes cannot be processed. Note, however, that claims for services and inpatient procedures provided before Oct. 1, 2014, must use ICD-9 codes.

Is training available on learning how to use the new ICD-10 codes?
Yes, comprehensive training resources will be available to affiliated physicians, THPG physicians, and employees of THR hospitals and THPG practices. Online training will be available beginning in April. Onsite training will be available from June through September 2014. The schedule will be posted in February. 

Codes change every year, so why is the transition to ICD-10 any different from the annual code changes?
ICD-10 codes are different than ICD-9 codes and have a completely different structure. Currently, ICD-9 codes are mostly numeric and have three to five digits. ICD-10 codes are alphanumeric and contain three to seven characters. ICD-10 is more robust and descriptive.

How will ICD-10 benefit my patients?
The new coding process will ultimately provide better data for measuring quality, safety and effectiveness of care; improving disease management; and coordinating care across the continuum.

What if I have questions about ICD-10?
To find answers to your questions, review the ICD-10 intranet site (Type ICD10 in the internet browser) or send an email to ICD-10@TexasHealth.org.

THPG Only

What support will THPG provide my practice?
Every process, system, application, program, report, database and interface that contains or involves an ICD-9 diagnosis or procedure code must be adapted or changed to accommodate ICD-10. THPG is working to align our IT programs with rigorous testing prior to Oct. 1, 2014, and we will provide your practice information and training for a smooth transition to ICD-10.

THPG coders submit our claims, so why does my practice need to be involved in the transition to ICD-10?
ICD-10 diagnosis codes are much more detailed than ICD-9 codes. It will be essential that practices understand the new codes and submit thorough documentation to support these high-specificity diagnoses.