Medicare Advantage Plans

ICD-10 Information

ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD). It contains codes that classify diseases and health problems. Scroll down to ICD-10 Frequently Asked Questions and Answers to learn more.

ICD-10 Implementation

The Centers for Medicare & Medicaid Services (CMS) has mandated the replacement of the International Classification of Diseases, Ninth Revision (ICD-9) diagnostic and procedure code sets with International Classification of Diseases, 10th Revision (ICD-10) Clinical Modification (CM) and Procedure Coding System (PCS). Oct. 1, 2015, was the implementation date set by CMS to begin using ICD-10 codes.

ICD-10 Frequently Asked Questions and Answers

ICD-10 is the International Classification of Diseases, 10th Revision. ICD is the international standard for diagnostic classifications.

All entities covered by the Health Insurance Portability and Accountability Act (HIPAA) must now conduct health care transactions using the ICD-10 diagnosis and procedure codes.

  • Q. What is CarePlus' standard for ICD-10 acceptance?

    A. CarePlus accepts ICD-10 codes on claims with a date of service or discharge date of Oct. 1, 2015, or after.

  • Q. Did CarePlus change medical necessity requirements because of the more specific codes that are available?

    A. Yes. CarePlus has reviewed and updated medical policies to incorporate new ICD-10 terminology and expanded coding.

  • Q. Did CarePlus update medical review policies, coverage determinations and payment determinations?

    A. Yes. CarePlus has reviewed and updated medical policies to incorporate new ICD-10 terminology and expanded coding.

  • Q. Who from CarePlus may I contact if I have questions about ICD-10?

    A. If health care providers have questions or concerns, they may submit an email to ICD10CPInquiries@careplus-hp.com. (link opens in new window)

Disclaimer: The information contained on this website is designed to provide a general overview of ICD-10 and should not be used as legal advice for implementation activities. We encourage you to seek any professional advice you may need, including legal counsel, regarding how the new requirements affect your specific practice. CarePlus is providing the information on this site for general informational purposes only.

If you are looking for ICD-10 information or training, CarePlus suggests contacting the American Medical Association, CMS, Workgroup for Electronic Data Interchange, American Health Information Management Association, American Academy of Professional Coders or other associations that provide ICD-10 training directly to health care providers.

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