Which agency is responsible for oversight and compliance of ICD-10?

The agency responsible for oversight and compliance of ICD-10 is the Center for Medicare and Medicaid Services (CMS). This organization plays a critical role in the healthcare system within the United States, overseeing important regulations related to medical coding and billing practices. ICD-10, which stands for the International Classification of Diseases, 10th Revision, is a system used to classify and code diagnoses, symptoms, and procedures recorded in conjunction with healthcare services. Compliance with ICD-10 is essential for accurate billing and reimbursement processes, particularly in Medicare and Medicaid programs.

CMS sets the required standards and guidelines for the implementation of ICD-10 to ensure that healthcare providers use the coding system correctly and consistently. This oversight helps to improve the quality of data regarding diseases and health conditions, which can significantly impact public health, research, and healthcare funding decisions.

In contrast, the World Health Organization (WHO), while responsible for the international version of the ICD and its revisions, does not oversee compliance within the U.S. healthcare system. The American Medical Association (AMA) is involved in representing physicians and advocating for healthcare practices, but it does not have the compliance authority that CMS holds. The National Institutes of Health (NIH) focuses on biomedical research and does not have a role