On October 1, 2013, the ICD-9 code sets used to report medical diagnosis and inpatient procedure codes will be replaced by ICD-10 code sets. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires the health care industry to use standard formats for electronic claims and claims-related transactions. To accommodate the ICD-10 code structure, the current versions of the transaction standards (the Accredited Standards Committee X12 Version 4010/4010A1 for health care transactions and the National Council for Prescription Drug Programs [NCPDP] Version 5.1 for pharmacy transactions) were modified under the Modifications to HIPAA Electronic Transaction Standards Final Rule, (see 74 Fed. Reg. 3296 (Jan. 16, 2009) and 74 Fed. Reg. 3328 (Jan. 16, 2009)). The current versions were replaced with Version 5010 and Version D.0, respectively. All those engaging in standard transactions, including providers, billing services, and health insurers, must implement Version 5010 and Version D.0 by January 1, 2012.

The CMS Fact Sheet is available here and the CMS webpage on Transactions and Code Sets Regulations is available here.