ICD-10 to ICD-9 Mapping

On the Main Menu, click Settings > Billing. In the left menu, under Practice Links — Miscellaneous, click ICD-10 to ICD-9 Mapping

You must have the Billing Admin: ICD-10 to ICD-9 Mapping permission to see this page. This permission is part of the Billing Admin role.

1. Display the ICD-10 to ICD-9 Mapping page: On the Main Menu, click Settings > Billing. In the left menu, under Practice Links — Miscellaneous, click ICD-10 to ICD-9 Mapping.
   If you are displaying this page for the first time and have not yet approved the mappings on the page, you are asked to click Approve to approve the mappings or Remind me later if you are not ready to approve them.
   
   
2. Click Approve or Remind me later. If you click Approve, you can still edit the mappings.
   
3. Use one or more of these options to filter the list of mappings.
   • Keyword — Enter a keyword, for example, "gout, right elbow."
   • ICD-10 code — Enter an ICD-10 code.
   • ICD-9 code — Enter an ICD-9 code.
   • Edited ICD-9 codes — Search for edited ICD-9 codes.
   • Reviewed ICD-9 codes — Search for reviewed ICD-9 codes.
   • Mappings that will hold claims — Search for ICD-10 to ICD-9 mappings that will cause claims to be held for manual review.
   • Most used ICD-10s by specialty — Select this option, then select a specialty from the menu.
   • Most used ICD-9s by specialty — Select this option, then select a specialty from the menu.
   • Non-specific ICD-9 codes — Search for non-specific ICD-9 codes.
     
4. Click Filter.
   The filtered list of mappings appears in the ICD-10 to ICD-9 Mapping table.
5. To approve all the mappings in the table, click the Reviewed option at the top left of the table.
6. To approve individual mappings, click the Reviewed option next to the specific mappings in the table.
7. To reset the filters and search for a different group of mappings, click Reset in the Filter By section at the top of the page.
   

1. Display the ICD-10 to ICD-9 Mapping page: On the Main Menu, click Settings > Billing. In the left menu, under Practice Links — Miscellaneous, click ICD-10 to ICD-9 Mapping.
   If you are displaying this page for the first time and have not yet approved the mappings on the page, you are asked to click Approve to approve the mappings or Remind me later if you are not ready to approve them.
   
   
2. Click Approve or Remind me later. If you click Approve, you can still edit the mappings.
3. Use one or more filter options to filter the list of mappings.
   
4. Click edit next to the ICD-10/ICD-9 mapping that you want to edit.
   The Edit Mapping view appears.
5. ICD-9 code — You can edit this field as follows:
   • Clear the Use CMS mapping checkbox, then enter a different ICD-9 code in the text box.
   • Select Hold claims with this mapping to hold claims with this code for manual review.
   • Select Use CMS Mapping to revert to the CMS mapping.
6. Notes — Enter any notes about this mapping. These notes will appear on the Charge Entry and Claim Edit pages, as well as in the ICD-10 to ICD-9 Mapping table.
7. Click Save and Mark as Reviewed.

Your practice should review any mappings relevant to your specialty and make any edits. You may want to start by reviewing codes used most frequently by your practice/specialty, including any non-specific mappings that may need to be updated with specific ICD-9 codes. Filters at the top of the page help you focus on your specialty and find specific mappings. You can also flag mappings to be held by a rule for manual review.

Note: For Enterprise clients, master table syncing is supported, with the overwrite option only.

In order for these mappings to take effect, you must approve their use. When you display the ICD-10 to ICD-9 Mapping page, athenaOne prompts you to approve the conversion process. Review the mappings relevant to your practice first. You need to approve the mapping only once. You can continue reviewing and editing mappings after you approve, and even after the transition to ICD-10.

Note: athenahealth is not responsible for reimbursement issues that result from changes to the default CMS mappings.

Although Billing staff can review and edit any converted ICD-9 codes on the Charge Entry and Claim Edit pages, athenahealth recommends that your practice use the ICD-10 to ICD‑9 Mapping page to help minimize disruption to their workflows after the transition to ICD‑10. Any changes made to the auto-mapped ICD-9 codes on individual claims will not affect the default mappings displayed on this page.

Reimbursement Map file

 

CMS publicly issued the Reimbursement Map file for converting ICD-10 diagnosis codes to ICD-9 diagnosis codes to limit disruptions to reimbursement. Nearly all billable ICD‑10 codes have been mapped to billable ICD-9 codes, except for a small number of codes in the Y700 chapter. athenahealth reviewed the nearly 70,000 mapped codes and flagged some of them to be held by a rule because we do not judge them to be clinically equivalent, but we did not edit any mappings.