ICD-10 and ICD 9-CM Diagnosis Code Tables Involving Non-

40.10 – ICD-10 and ICD 9-CM Diagnosis Code Tables Involving Non- GHP MSP Claims (Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23) In accordance with The Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Secretary of the Department of Health and Human Services adopts standard medical data code sets for use in standard transactions. According to the ICD-10 final rule, published in the Federal Register on January 16, 2009, the Secretary adopted the ICD-10-CM and ICD-10- PCS code sets for use in appropriate HIPAA standard transactions, including those for submitting health care claims electronically. Entities covered under HIPAA, which includes Medicare and its providers submitting claims electronically, are bound by these requirements and must comply. Medicare also requires submitters of paper claims to use ICD-10 codes on their claims according to the same compliance date. CMS annually instructs CWF to upload and implement the ICD-10 tables in CWF for NGHP MSP claims transactions. In order to be prepared to meet the time line to implement the annually updated ICD-10 diagnosis codes by the mandated time frame of October, CWF implements the ICD-10 updates effective with each October release. CMS also provides CWF with the Diagnosis and Procedure Codes Conversion Tables that are used to associate ICD-10 codes to ICD-9 codes found in CWF MSP records. CWF loads and converts ICD-10 to ICD-9 diagnosis codes for purposes of determining whether ICD 10 diagnosis codes on incoming MSP claim are related to the NGHP MSP record in CWF.