ICD-10-CM Diagnosis Codes for Audiology and Speech-Language Pathology

(International Classification of Diseases, 10^th Revision, Clinical Modification)

Beginning October 1, 2014, you will be required to use the new ICD-10 system, which will replace the current ICD-9-CM (International Classification of Diseases, 9^th Revision, Clinical Modification) Volumes 1, 2, and 3 used to report health care diagnoses, disorders, and inpatient hospital procedures. The new ICD-10 will include the ICD-10-CM (clinical modification) for diagnosis codes and the ICD-10-PCS (procedure coding system) for inpatient hospital procedures. This page will focus primarily on ICD-10-CM.

The codes in ICD-10 are not valid for any purpose or use in the United States until October 1, 2014 (tentative date).

On this page:

• Why the Switch?
• Differences Between ICD-9-CM and ICD-10-CM
• General Equivalency Mappings (GEMs)
• Converting from ICD-9-CM to ICD-10-CM: Will You Be Ready?

Why the Switch?

The Centers for Disease Control and Prevention (CDC) developed the new ICD-10-CM classification system because the ICD-9-CM is running out of codes. Hundreds of new diagnosis codes are submitted annually. The ICD-9-CM is 30 years old, has outdated and obsolete terminology, and produces limited data. ICD-10-CM will allow for more codes and greater specificity and thus better data tracking of incidence and prevalence of disease.

The ICD-10 is owned by the World Health Organization (WHO) and ICD-10-CM is the United States' modification of the ICD-10.

Differences Between ICD-9-CM and ICD-10-CM

The ICD-10-CM codes are based on an alpha-numeric system that is very different from the current ICD-9-CM numeric-only system. ICD-9 consists of approximately 13,000 codes while ICD-10 has approximately 68,000 available codes and provides more flexibility for adding new codes. ICD-9 lacks detail whereas ICD-10 is very specific. This may mean a decreased need to include supporting documentation with claims. ICD-10 will provide better data for processing claims, making clinical decisions, tracking public health, conducting research, and identifying fraud and abuse. Additionally, conditions have been grouped in a more logical fashion than in ICD-9. This may have been accomplished by means of movement from one chapter to another or one section to another. Many codes have been added to, deleted from, combined, or moved in ICD-10.

ICD-10 codes are three to seven characters in length. The first character is alpha, the second is numeric, and the third through seventh characters are either alpha or numeric. Valid codes can have anywhere from three to seven digits.

Example of ICD-9-CM vs. ICD-10-CM Codes

General Equivalency Mappings (GEMs)

GEMs were developed by the Centers for Medicare and Medicaid Services (CMS) and the CDC as a tool to assist with the conversion from ICD-9-CM codes to ICD-10-CM and ICD-10-PCS. The GEMS are forward and backward mappings between ICD-9 and ICD-10 and are also referred to as crosswalks. However, in some instances, there is not a translation between an ICD-9 code and an ICD-10 code, which will be noted with a "No Map" flag indicator. ASHA is analyzing the GEMs and other resources to apply the appropriate mappings for audiology and speech-language pathology related diagnoses.

Converting from ICD-9-CM to ICD-10-CM: Will You Be Ready?

Important Compliance Dates

March 31, 2012: All Health Insurance Portability and Accountability Act (HIPAA) covered entities must have converted to Version 5010 of the HIPAA transaction standards, which are the national standards used in billing software. Any electronic transaction subject to the standards must be submitted using Version 5010 on or after this date. The original deadline was January 1, 2012.

October 1, 2014: Diagnosis coding in health care settings will change from ICD-9 to ICD-10, regardless of whether you are covered by HIPAA or not. (Note: See the note above regarding the delay of the implementation date. The original date for compliance was October 1, 2013.)

Preparing now will help you avoid potential reimbursement issues.

See also: CMS ICD-10 Implementation Timelines & Checklists

Resources to Help Get You There

• ICD-10 Preparation Checklist
• National Center for Health Statistics ICD-10 Web site
• Centers for Medicare and Medicaid Services ICD-10 Web Site
• For HIPAA Covered Entities: Transition to Version 5010

How is ASHA Going to Help Me Get Ready?

ASHA is preparing a mapping (conversion) tool for ICD-9 to ICD-10 codes used by audiologists and speech-language pathologists, to be made available in June 2013.

The new classification system provides significant changes and ASHA will assist members as they make the transition. Critical information will be posted here on this webpage and/or relayed through various communication vehicles, including The ASHA Leader. Members may also contact ASHA with specific questions regarding the transition at reimbursement@asha.org or 800-498-2071.