OBJECTIVE: On October 1, 2013, the reporting of diagnoses and procedures in the U.S. will transition  from the clinical modification of the ninth revision of the International Classification of Diseases (ICD-9-CM) to the  tenth revision (ICD-10). We estimate the impact of conversion to ICD-10 on Medicare MS-DRG payments to hospitals using  2009 Medicare data.METHODS: Using the ICD-9-CM MS-DRG v27 (FY 2010), the converted ICD-10 MS-DRG v27, and the ICD-10  to ICD-9-CM Reimbursement Map for fiscal year 2010, we estimate the impact on aggregate payments to hospitals and the  distribution of payments across hospitals.RESULTS: Although the transition from the ICD-9-CM to the ICD-10 version of  MS-DRGs resulted in 1.68 percent of the patients being assigned to a different MS-DRG, payment increases and decreases  due to the changes in MS-DRG assignment essentially netted out, resulting in a minimal impact on aggregate payments to  hospitals (+0.05 percent) and on the distribution of payments across hospital types (-0.01 to +0.18 percent). Mapping  ICD-10 data back to ICD-9-CM, and using the ICD-9-CM MS-DRGs, resulted in 3.66 percent of patients being assigned to a  different MS-DRG, a modest decrease in aggregate payments to hospitals (-0.34 percent), and modest changes in the  distribution of payments across hospital types (-0.14 to -0.46 percent).DISCUSSION: As demonstrated by MS-DRGs, a direct  conversion of an application to ICD-10 can produce consistent results with the ICD-9-CM version of the application.  However, the use of mappings between ICD-10 and ICD-9-CM will produce less consistent results, especially if the mapping  is not tailored to the specific application.
Diagnosis-Related Groups Economics, Hospital