ICD-10 FAQ List Revised to Clarify Billable Code

The ICD-10 FAQ list helps healthcare providers understand the transition to ICD-10 and apprises them of the flexible policies CMS will be practicing in the first year following implementation. CMS recently updated the FAQ list to clarify misunderstandings regarding family codes and what qualifies as a billable or valid code. Along with the FAQ list, there is also a free coding book featuring all ICD-10 claim codes, which can benefit providers during the transition. 

CMS provides explanations on what a billable claim code is and the different code classifications in question 3. CMS states that family codes are not billable codes unless the disease cannot be broken down any further. For example, C81 is the 3-character code for Hodgkin’s lymphoma, but that is not valid. The billable code would be C81.03 for Nodular lymphocyte predominant Hodgkin lymphoma, intra-abdominal lymph nodes, which provides a highly specified diagnosis. CMS also revised question 5 by giving providers a definition of a family code in general diagnosis. For example, K50 is the family code for Crohn’s disease, and K50.90 is the specific code for Crohn's disease, unspecified, without complications. The revisions made for question 3 and 5 gave more specificity and examples to further explain new ICD-10 coding.

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