Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
www.mass.gov/masshealth
	MassHealth
	All Provider Bulletin 228
	July 2012


	TO:	All Providers Participating in MassHealth

	FROM:	Julian J. Harris, M.D., Medicaid Director 

	RE:	Information about ICD-10-CM/PCS


Background	
On January 16, 2009, the U.S. Department of Health and Human 
Services (HHS) published a final rule on the International Classification of 
Diseases, 10th Edition, Clinical Modification/Procedure Coding System 
(ICD-10-CM/PCS), requiring all HIPAA-covered entities to adopt the ICD-
10-CM/PCS (diagnosis/inpatient procedure codes) by October 1, 2013. 
On April 9, 2012, HHS announced that it would delay the compliance 
date for ICD-10-CM/PCS from October 1, 2013, to October 1, 2014.
Effective October 1, 2014, claims submitted to MassHealth must include 
the ICD-10-CM diagnosis codes. In addition, claims for inpatient services 
with a date of discharge on or after October 1, 2014, must contain the 
new ICD-10 inpatient procedure code set.
	
Code Changes	
ICD-10 will expand the number of diagnosis and inpatient service codes 
that must be used to provide greater specificity on claim submissions. 
The following table displays the high-level differences between ICD-9 and 
ICD-10-CM and -PCS codes.

Code Changes
ICD-9
ICD-10
Diagnosis (CM)
3,000 codes
72,081 codes
3-5 digits 
(alpha/numeric)
3-7 digits 
(alpha/numeric)
Inpatient Procedure Coding 
System (PCS)
13,000 codes
68,000 codes
3-4 digits (numeric)
7 digits 
(alpha/numeric)

Please Note: Providers will need to adopt only those codes that are 
relevant to their day-to-day operations. Providers should also evaluate the 
new ICD-10 codes (i.e., codes that do not have an ICD-9 counterpart) to 
determine the relevance and impact to their operation.
	
                                               (continued on next page)

MassHealth
All Provider Bulletin 228
July 2012
Page 2


	
MassHealth’s Approach	
MassHealth will inform providers of the status of its ICD-10 
implementation by providing guidance, relevant billing information, 
training, and educational materials. Trading partner testing will also be 
conducted to ensure the accurate acceptance, adjudication, and payment 
of ICD-10 claims.
                          
Additionally, MassHealth has developed an ICD-10 web page to 
communicate key information to providers related to the preparation and 
implementation of ICD-10. The website contains links to key CMS-support 
materials, outlines the latest MassHealth project status, and will contain 
billing, communication, and training documentation to aid in the 
successful implementation of ICD-10.

The website is located at www.mass.gov/masshealth/icd-10. Providers 
should monitor this page to view important MassHealth ICD-10 
information as it becomes available.
	

Questions	
If you have any questions about the information in this bulletin, please 
contact MassHealth Customer Service at 1-800-841-2900, e-mail your 
inquiry to providersupport@mahealth.net, or fax your inquiry to 
617-988-8974.