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?
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.
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*:
*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.