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Washington State Dental Association

ICD-10 Compliance Deadline Delayed

On Monday, April 1, 2014, H.R. 4302 was signed by President Obama pushing the ICD-10 compliance deadline to October of 2015. ICD-10 contains two sets of codes; ICD-10-CM-Clinical Modification (these codes may be used in medicine and dentistry) and ICD-10-PCS- Procedure Coding System (will be used in hospitals only). ICD-10-CM stands for International Classification of Diseases, Tenth Revision, Clinical Modification. 

Dentistry will continue to use CDT codes for reporting procedures on dental claims and any use of ICD-10-CM will be a situational requirement for electronic dental claims. Dentists may or may not need to use an ICD-10-CM code in addition to a CDT code to obtain payment depending if there is a presence of a systemic condition that requires particular oral health services. For example, if a patient was diabetic they could be eligible for an additional prophylaxis through their dental plan. The claim for this patient would then include the procedure code and ICD-10-CM diagnostic code. ICD-10 was implemented by the World Health Organization in 1993. ICD-10-CM is more detailed and contains more diagnostic concepts than ICD-9-CM. 


In order to implement the ICD-10 codes, dentists who submit electronic claims may need to update their billing systems. Contact your software vendors soon about the ICD-10 upgrades and make sure to familiarize your staff with the new completion instructions. Dentists who submit paper claims will need to make sure they are using updated claim forms. Click here to view a sample of the most up-to-date ADA Claim Form. 


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