Glossary, documentation
What is ICD-10 coding?
ICD-10 coding is the assignment of codes from the tenth revision of the International Classification of Diseases, published by the World Health Organization, to the diagnoses and reasons for a visit in a patient record. Insurers use the codes to pay claims, and health systems use them to report illness and causes of death.
Updated . Defined by the wai team for clinics, groups and health systems.
Also called ICD-10, ICD-10-CM or International Classification of Diseases.
Why ICD-10 coding matters to a clinic
Most private insurers and national claims systems expect a diagnosis code on every claim. In the United States, the health care industry moved from ICD-9 to ICD-10 on 1 October 2015, and ICD-10 applies to every party covered by HIPAA.1
The newer WHO revision, ICD-11, came into effect on 1 January 2022,2 while many countries and payers still run on ICD-10 or a national version of it. A clinic should know which version each payer expects.
A code is only as good as the note behind it. When the code is drafted from the signed note and the supporting lines sit beside it, a claim query is answered from the record.
Questions
Is ICD-10 still used now that ICD-11 exists?
Yes. ICD-11 came into effect on 1 January 2022,2 and many payers and countries still require ICD-10 or a national version of it, such as ICD-10-CM in the United States.
Who checks the code before a claim?
The clinician or the billing team. wai proposes the code with the lines behind it, and a person accepts or changes it before the claim goes. See billing.
Sources
See wai on your own clinic.
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