What is ICD-10?

The International Classification of Diseases, Tenth Edition (ICD-10) is a clinical cataloging system that goes into effect for the U.S. healthcare industry on October 1, 2015 and replaces ICD-9. ICD-10 codes offer many more classification options compared to those found in predecessor ICD-9.

When do I begin using ICD-10?

Claims for all health care services performed on or after October 1, 2015, must use ICD-10 diagnosis codes in order to be processed by Medicare and many other government and commercial payers. ICD-9 codes should continue to be used for services performed through September 30, 2015.

How does it impact claims associated with Bioventus products?

EXOGEN

Under the new ICD-10 coding system, physicians not only will need to code each fracture, but also use separate codes to account for other unique identifiers such as site within the bone (metaphyseal, diaphyseal); laterality (left, right, bilateral); pattern of fracture (Neer 3 part); status of fracture (healing, nonunion, malunion, delayed union); place of occurrence (field, sidewalk, street, etc.); and cause of fracture (MVA, sporting activity, fall, etc.). The specific diagnosis where EXOGEN may be deemed a coverable treatment may vary depending on the patients’ payer and policy. Please check with the patients’ insurance carrier to obtain the coverage policy.

SUPARTZ

In preparation for the transition from ICD-9 to ICD-10 medical coding many health plans include a listing of the ICD-10 codes associated with their coverage policy. Please contact the patients’ insurer for a list of the specific ICD-10 codes that qualify for SUPARTZ treatment prior to administration.

How can I get more information on ICD-10?

A great deal of information can be found on the CMS website. Click here for more information.

In order to assist you in the transition from ICD-9 to ICD-10, a number of organizations have also put up web based general equivalence mapping (GEM) tools that will allow you to enter an ICD-9 code to find the corresponding ICD-10 codes. Below are several of these sites*:

ICD-9 to ICD-10 Conversion Tool
ICD-10 Code Search
ICD-10 Code Translator

*Bioventus is not responsible for the content in these sites and cannot warrant the correctness or appropriateness of the data they provide.

Please note that GEMS do not always provide a direct translation and there is no guarantee that a covered
ICD-9 will translate into a covered ICD-10 code for a specific treatment. You should always confirm with the patient’s insurer to avoid denied claims.